Ivermectin
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First report of hepatitis: case report A 20-year-old women developed severe hepatitis after treatment with ivermectin for loiasis. The patient, who had received albendazole, received singledose ivermectin 15mg (300 µg/kg) to further reduce microflaraemia. During routine follow-up visit 1 month later, she reported moderate new diffuse abdominal pain [time to reaction onset not clearly stated]. On examination, she had upper-right quadrant tenderness. Laboratory investigations showed elevated ALT and AST levels of 907 IU/L (normal 7–42) and 279 IU/L (5–39), respectively. Liver biopsy tests showed predominantly perivenular intralobular inflammatory infiltrates, with conglomeration of ceroid loaded macrophages and confluent necrosis and apoptosis; her biopsy results were compatible with resolving acute drug-induced hepatitis. Her symptoms resolved after a few days. All of her liver enzymes returned to normal values 4 months after the onset of hepatitis; she had ALT and AST levels of 23 IU/L and 20 IU/L, respectively. [Treatment given not stated.] Author comment: "The shorter interval between administration of ivermectin and the onset of symptoms, liver histology compatible with hepatocellular toxicity, and no history of other agents causing hepatitis all point to ivermectin as causative agent of the drug-induced liver disease in our patient." Veit O, et al. First case of ivermectin-induced severe hepatitis. Transactions of the Royal Society of Tropical Medicine and Hygiene 100: 795-797, No. 8, Aug 2006 801041085 Switzerland
» Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of hepatitis associated with ivermectin. The WHO Adverse Drug Reactions database contained one report of hepatitis associated with ivermectin.
0114-9954/10/1109-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 8 Jul 2006 No. 1109
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