title: A case of flutamide-induced acute cholestatic hepatitis--a case report.
abstract: Flutamide, an oral nonsteroidal, antiandrogenic, anilid compound which inhibits the uptake and binding of androgens to nuclear receptors in the prostate, is used with or without LH-RH analogues for treatment of patients with metastatic carcinoma of the prostate. Clinically significant hepatotoxicities such as toxic hepatitis, cholestatic hepatitis, hepatic failure, and even death have rarely been reported in the English literature, but no case has been reported in Korea. A 75-year-old man with metastatic carcinoma of the prostate had taken flutamide (750 mg/day) for 7 months and suddenly developed jaundice and general weakness. The findings of blood chemistries were compatible with cholestatic hepatitis, but ultrasonography, viral marker and auto-antibody studies did not reveal any attributable causes. Histologic examination of a sono-guided liver biopsy only disclosed centrilobular cholestasis, nuclear glycogenosis and mild sinusoidal lymphocytic infiltration. Discontinuation of flutamide resulted in an almost full recovery of the patient's liver function in 2 months. We, herein, report a case of flutamide-induced acute choestatic hepatitis with a brief review of the literature.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Lee
authors.forename: J P
authors.initials: JP
authors.lastname: Chung
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.forename: K C
authors.initials: KC
authors.lastname: Kim
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.forename: C Y
authors.initials: CY
authors.lastname: Chon
authors.forename: I S
authors.initials: IS
authors.lastname: Park
authors.forename: H G
authors.initials: HG
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002779:Cholestasis / Q000139:chemically induced*; D005485:Flutamide / Q000009:adverse effects*; D006801:Humans; D008297:Male
chemical_list: D000726:Androgen Antagonists; D005485:Flutamide