Doxycycline
- PDF / 170,647 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 47 Downloads / 176 Views
1 S
Drug-induced mixed-type liver injury: case report A 57-year-old man developed drug-induced mixed-type liver injury during treatment with doxycycline for the exacerbation of chronic obstructive pulmonary disease. The man presented to a hospital in USA with the complaints of chest discomfort, shortness of breath and productive cough for 1 day. He had a medical history of hypertension, diabetes mellitus, chronic obstructive pulmonary disease, hyperlipidaemia, coronary artery disease and deep venous thrombosis. He denied any known allergies to medications. He had been receiving apixaban, aspirin, carvedilol, atorvastatin, furosemide, gabapentin, valsartan/hydrochlorothiazide [valsartan-hydrochlorothiazide] and insulin. After thorough investigation, he was considered to have an exacerbation of chronic obstructive pulmonary disease. He was hospitalised and was started on a non-invasive ventilation for respiratory support. Additionally, he started receiving prednisone, ipratropium-bromide/salbutamol [albuterol-ipratropium] nebulisation and doxycycline 200mg once a day [route not stated]. The following day, laboratory tests showed that AST increased from 15 to 532, ALT rose from 22 to 425, alkaline phosphatase (ALP) elevated from 138 to 370. He developed new-onset mild right upper quadrant abdominal pain and nausea. He tested negative for antibodies to hepatitis A, B and C as well as for markers of acute cytomegalovirus and Epstein Barr virus infection. Autoantibodies were negative and INR was normal. Abdominal ultrasound showed normal right upper quadrant. Doxycycline-induced liver injury was suspected. The R factor for liver injury was 3.4, which was compatible with a mixed pattern of liver injury. Doxycycline was switched to azithromycin. The following day, symptoms of abdominal pain improved. The man also reported an overall improvement in the respiratory status. Over the period of following 5 weeks, the liver enzymes levels were downtrending to normal levels. He showed complete recovery. Owing to the temporal causal relationship, his symptoms and biochemical abnormalities were attributed to doxycycline. He had received doxycycline in the past without adverse effects. The short interval between initiation of doxycycline and the onset of liver test abnormality could suggest previous sensitization and an immune allergic aetiology. Roussel-Uclaf Causality Assessment Method showed highly probable relationship between liver injury and doxycycline. Kooragayalu S, et al. Doxycycline: Rare but real cause of dili (drug-induced liver injury). International Journal of Pharmaceutical Research 12 (Suppl. 1): 655-657, Jan-Jun 803502949 2020. Available from: URL: http://doi.org/10.31838/ijpr/2020.SP1.053
0114-9954/20/1823-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 26 Sep 2020 No. 1823
Data Loading...
