[Hepatitis after treatment with cyproterone acetate. Apropos of a case].
Regarding a case of little-differentiated adenocarcinoma of prostate in a 79-year old male patient undergoing antiandrogenic corticosteroid therapy (cyproterone acetate), the authors describe a rare complication related to treatment with the drug. Cytolytic icterus, without cholestasis, occurred eleven weeks after starting the treatment without metastasis of the primary cancerous lesion, and regressed when administration of the antiandrogenic agent was interrupted. This description is compatible with toxic hepatitis. This is a rare complication, which should be differentiated from stasis icterus consecutive to treatment with progestogens. Its diagnosis precludes also primary or drug-induced secondary tumors or degenerative hepatic lesions. A knowledge of this complication by the urologist is important, so the latter might not conclude too hastily to metastatic extension of primary cancer of prostate. Withdrawal of the patient from antiandrogenic therapy is mandatory, and management should incorporate complete biological investigation of liver function, CT scans and, depending upon the case, liver biopsy as the only means of studying this exceptionally rare complication.
Dore
B
B
Service d'Urologie, CHU de Poitiers.
Orget
J
J
Irani
J
J
Aubert
J
J
D000230:Adenocarcinoma / Q000188:drug therapy; D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D003534:Cyproterone / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017373:Cyproterone Acetate; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy
D017373:Cyproterone Acetate; D003534:Cyproterone
Hépatite après traitement par acétate de cyprotérone. A propos d'un cas.