Troglitazone-Associated Hepatotoxicity Treated Successfully with Steroids
Authors: Kathleen A. Prendergast
Journal: Annals of Internal Medicine (2000)

Letters7 November 2000Troglitazone-Associated Hepatotoxicity Treated Successfully with SteroidsKathleen A. Prendergast, MD, Carl L. Berg, MD, and Ralph Wisniewski, MDKathleen A. Prendergast, MDUniversity of Virginia Health Science Center; Charlottesville, VA 22908-0708 (Prendergast, Berg, Wisniewski)Search for more papers by this author, Carl L. Berg, MDUniversity of Virginia Health Science Center; Charlottesville, VA 22908-0708 (Prendergast, Berg, Wisniewski)Search for more papers by this author, and Ralph Wisniewski, MDUniversity of Virginia Health Science Center; Charlottesville, VA 22908-0708 (Prendergast, Berg, Wisniewski)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-9-200011070-00034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 59-year-old diabetic man was referred to a transplantation clinic with progressive liver dysfunction. He had begun feeling increasingly fatigued 5 months earlier. Liver enzyme levels were elevated (alanine aminotransferase [ALT] level, 8350 nkat/L; aspartate aminotransferase [AST] level, 4.98 µkat/L), and troglitazone and simvastatin therapies were stopped. During the next 8 weeks, aminotransferase levels continued to increase to 21 667 nkat/L, and the bilirubin level increased from normal to 308 µmol/L (18 mg/dL) (Figure).Figure.Relationship of alanine aminotransferase level to cessation of troglitazone therapy and initiation of steroid therapy.To convert alanine aminotransferase values to nkat/L, divide by ...References1. Vella A, de Groen PC, Dinneen SF. Fatal hepatotoxicity associated with troglitazone [Letter]. Ann Intern Med. 1998;129:1080. LinkGoogle Scholar2. Watkins PB, Whitcomb RW. Hepatic dysfunction associated with troglitazone [Letter]. N Engl J Med. 1998;338:916-7. CrossrefMedlineGoogle Scholar3. Gitlin N, Julie NL, Spurr CL, Lim KN, Juarbe HM. Two cases of severe clinical and histologic hepatotoxicity associated with troglitazone. Ann Intern Med. 1998;129:36-8. LinkGoogle Scholar4. Neuschwander-Tetri BA, Isley WL, Oki JC, Ramarakhiani S, Quiason SG, Phillips NJ, et al . Troglitazone-induced hepatic failure leading to liver transplantation. A case report. Ann Intern Med. 1998;129:38-41. LinkGoogle Scholar5. Shibuya A, Watanabe M, Fujita Y, Saigenji K, Kuwao S, Takahashi H, et al . An autopsy case of troglitazone-induced fulminant hepatitis. Diabetes Care. 1998;21:2140-3. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Virginia Health Science Center; Charlottesville, VA 22908-0708 (Prendergast, Berg, Wisniewski) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThiazolidinedione drugs in the treatment of type 2 diabetes mellitus: past, present and futureHepatic Failure Related to Itraconazole Use Successfully Treated by CorticosteroidsImportant Elements for the Diagnosis of Drug-Induced Liver InjuryInflammatory Stress and Idiosyncratic Hepatotoxicity: Hints from Animal ModelsTroglitazone and liver injury: In search of answersHepatotoxicity of thiazolidinediones“Did This Drug Cause My Patient's Hepatitis?” and Related QuestionsDavid W. Nierenberg, MDLiver failure in a patient treated with long-term rosiglitazone therapyDrug-induced liver diseaseCurrent AwarenessTroglitazone 7 November 2000Volume 133, Issue 9Page: 751KeywordsAlanine aminotransferaseBilirubinEnzymesLiverLiver diseasesSerum glutamic oxaloacetic transaminaseSteroid therapySteroidsTransplantationUltrasound imaging ePublished: 7 November 2000 Issue Published: 7 November 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...