Levetiracetam
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Levetiracetam Liver injury: case report
A 29-year-old man developed liver injury (hepatocellular injury) during treatment with levetiracetam for seizure prophylaxis. The man was admitted to a hospital in unconscious state with left hemiplegia. He was eventually diagnosed with intracerebral haematoma. His medical history was significant for hypertension. He also reported consumption of alcohol in moderate amounts for the last 5 years. Thus, he underwent emergency craniotomy and evacuation of intracerebral haematoma. Baseline laboratory tests (liver function test, haemogram and prothrombin time) were normal. He started then receiving levetiracetam [dosage and route not stated] for seizure prophylaxis. Five days later, he developed high coloured urine and fever. Subsequent liver function test revealed a rise in serum bilirubin (5 mg/dL) and increased liver enzymes (ALT 267 u/L, AST 241 u/L, serum albumin 3.6 g/L and INR 1.6). It was suspected that the hepatocellular liver injury was induced by levetiracetam. The man’s therapy with levetiracetam was therefore discontinued. A serum test for hepatitis A, B, C and E markers were all negative. An abdominal ultrasound revealed no dilatation of the biliary tract and the size of the liver and echo textures were also normal. Three days after levetiracetam discontinuation, the liver enzymes and bilirubin started to decrease. Based on the temporal relationship between levetiracetam and onset of liver injury and based on CIOMS - RUCAM scale (a score of 8), a probable causal relation was accessed between levetiracetam and the hepatocellular injury. Gayatri P, et al. Levetiracetam-Induced Hepatic Dysfunction. Neurology India 68: 910-912, No. 4, Jul-Aug 2020. Available from: URL: http:// doi.org/10.4103/0028-3886.293452
0114-9954/20/1822-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
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Reactions 19 Sep 2020 No. 1822
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