title: Fatal acute fulminant liver failure due to clozapine: a case report and review of clozapine-induced hepatotoxicity.
abstract: Clozapine-induced hepatotoxicity is not well known and is usually of no clinical significance. This report describes fatal acute fulminant liver failure caused by clozapine in a 39-year-old man with chronic paranoid schizophrenia. The hepatotoxicity of clozapine is reviewed. Asymptomatic elevation of transaminase levels is observed most commonly, affecting between 30% and 50% of patients. Icteric hepatitis is uncommon, noted in 84 of 136,000 patients (0.06%). Fatal acute fulminant hepatitis has been documented in 2 patients (0.001%). The mechanism of clozapine hepatotoxicity is unknown. Although serious toxicity is rare, prescribers of clozapine should be aware of the hepatotoxic potential.
authors.affiliation: Department of Medicine, Royal Free Hospital School of Medicine, London, England.
authors.forename: B
authors.initials: B
authors.lastname: Macfarlane
authors.forename: S
authors.initials: S
authors.lastname: Davies
authors.forename: K
authors.initials: K
authors.lastname: Mannan
authors.forename: R
authors.initials: R
authors.lastname: Sarsam
authors.forename: D
authors.initials: D
authors.lastname: Pariente
authors.forename: J
authors.initials: J
authors.lastname: Dooley
mesh_terms: D000208:Acute Disease; D000328:Adult; D003024:Clozapine / Q000506:poisoning* / Q000627:therapeutic use; D017809:Fatal Outcome; D006501:Hepatic Encephalopathy / Q000139:chemically induced*; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008297:Male; D012563:Schizophrenia, Paranoid / Q000188:drug therapy
chemical_list: D003024:Clozapine