Severe Hepatotoxicity Associated with Troglitazone
Authors: Steven K. Herrine
Journal: Annals of Internal Medicine (1999)

Letters19 January 1999Severe Hepatotoxicity Associated with TroglitazoneSteven K. Herrine, MD and Cuckoo Choudhary, MDSteven K. Herrine, MDThomas Jefferson University; Philadelphia, PA 19107Search for more papers by this author and Cuckoo Choudhary, MDThomas Jefferson University; Philadelphia, PA 19107Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-2-199901190-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Two brief communications reported severe hepatotoxicity related to use of troglitazone (Rezulin, Parke-Davis, Morris Plains, New Jersey), an oral hypoglycemic agent (1, 2). We report a similar case.A 52-year-old woman with type 1 diabetes began receiving troglitazone, 400 mg/d, 20 weeks before presentation. She presented with lower-extremity edema, fatigue, and progressive jaundice. Other medications were lansoprazole, 30 mg/d; l-thyroxine, 0.2 mg/d; and simvastatin, 20 mg/d. She had no known exposure to hepatitis viruses or hepatotoxins and no history of alcohol ingestion. On physical examination, she was not encephalopathic, was deeply jaundiced, had a liver span of ...References1. 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 Scholar2. Neuschwander-Tetri BA, Isley WL, Oki JC, Ramrakhiani 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 Scholar3. Watkins PB, Whitecomb RW. Hepatic dysfunction associated with troglitazone. N Engl J Med. 1988;338:916-7. CrossrefGoogle Scholar4. Misbin RI. Review of liver toxicity of troglitazone. Meeting of the Food and Drug Administration. Bethesda: Cardiorenal Advisory Committee; 21 January 1998. Google Scholar Author, Article, and Disclosure InformationAuthors: Steven K. Herrine, MD; Cuckoo Choudhary, MDAffiliations: Thomas Jefferson University; Philadelphia, PA 19107 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug‐Metabolism Enzymes and Transporter Activities as Risk Factors of Selected Marketed Drugs Associated with Drug‐Induced FatalitiesCan Antidiabetic Drugs Improve Male Reproductive (Dys)Function Associated with Diabetes?Evaluation of Drug Biliary Excretion Using Sandwich-Cultured Human HepatocytesThiazolidinedione drugs in the treatment of type 2 diabetes mellitus: past, present and futureAntidiabetic therapies and male reproductive function: where do we stand?How to Avoid Being Surprised by Hepatotoxicity at the Final Stages of Drug Development and ApprovalHepatotoxicity of Cardiovascular and Antidiabetic DrugsRegulatory PerspectivesAssessment of Compound Hepatotoxicity Using Human Plateable Cryopreserved Hepatocytes in a 1536-Well-Plate FormatThe emergence of designed multiple ligands for neurodegenerative disordersThe safety of thiazolidinedionesMultimodal drugs and their future for Alzheimer's and Parkinson's diseaseRole of Peroxisome Proliferator-Activated Receptor-.GAMMA. in Atherosclerosis - An Update -Improving the Reporting of Adverse Drug Reactions in the Hospital SettingDrug Induced Liver Disease: Mechanisms and DiagnosisImportant Elements for the Diagnosis of Drug-Induced Liver InjuryThe Impact and In Vitro to In Vivo Prediction of Transporter-Based Drug–Drug Interactions in HumansPrediction of Severe Adverse Drug Reactions Using Pharmacogenetic BiomarkersThe Role of Drug Metabolism and Metabolite Identification in Drug DiscoveryRechallenge in drug-induced liver injury: the attractive hazardMitochondrial dysfunction and delayed hepatotoxicity: another lesson from troglitazoneEffect of troglitazone on CYP1A1 inductionIdiosyncratic drug hepatotoxicity: a 2008 updateChapter 2 Drug-Induced Hepatotoxicity: Learning from Recent Cases of Drug AttritionThe role of transporters in drug interactionsThe Toxicology of Ligands for Peroxisome Proliferator-Activated Receptors (PPAR)Gene Expression Analysis of Troglitazone Reveals Its Impact on Multiple Pathways in Cell Culture: A Case for In Vitro Platforms Combined with Gene Expression Analysis for Early (Idiosyncratic) Toxicity ScreeningINVESTIGATION OF PROTEOMIC BIOMARKERS IN IN VIVO HEPATOTOXICITY STUDY OF RAT LIVER: TOXICITY DIFFERENTIATION IN HEPATOTOXICANTSTroglitazone and liver injury: In search of answersThiazolidinediones and InsulinCausality assessment in drug-induced hepatotoxicityThiazolidinediones: comparison of long-term effects on glycemic control and cardiovascular risk factorsDrug-Induced Cholestatic Liver DiseaseHepatotoxicity of thiazolidinedionesHepatotoxicity of the thiazolidinedionesDrug-induced cholestasisTroglitazone-induced liver failure: a case studyAmphipathic 3-Phenyl-7-propylbenzisoxazoles; human pPaR γ, δ and α agonistsIncidence of idiopathic acute liver failure and hospitalized liver injury in patients treated with troglitazoneCorrelation between troglitazone cytotoxicity and drug metabolic enzyme activities in cryopreserved human hepatocytesTroglitazone enhances the hepatotoxicity of acetaminophen by inducing CYP3A in ratsEvaluation of Liver Function in Type 2 Diabetic Patients During Clinical Trials“Did This Drug Cause My Patient's Hepatitis?” and Related QuestionsDavid W. 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