Troglitazone-induced hepatic failure leading to liver transplantation. A case report.
BACKGROUND
Troglitazone is a new drug for the treatment of type 2 diabetes. Although mild liver injury occurred in 1.9% of participants in controlled trials, the U.S. Food and Drug Administration has received reports of five postmarketing cases of severe liver disease that resulted in death or liver transplantation.


OBJECTIVE
To report the clinical and histopathologic characteristics of a patient with troglitazone-associated severe liver injury leading to transplantation.


METHODS
Case report.


METHODS
Two university hospitals.


METHODS
A 55-year-old woman taking troglitazone, 400 mg/d, and insulin, 120 U/d.


METHODS
Discontinuation of troglitazone therapy, pretransplantation liver biopsy, and liver transplantation.


RESULTS
Early nonspecific symptoms were attributed to other causes and were not evaluated. After the patient had used troglitazone for 3.5 months, massive loss of liver parenchyma and symptoms of liver failure developed, necessitating liver transplantation.


CONCLUSIONS
Troglitazone may cause subfulminant liver failure.
Neuschwander-Tetri
B A
BA
St. Louis University School of Medicine, Missouri 63110, USA.
Isley
W L
WL
Oki
J C
JC
Ramrakhiani
S
S
Quiason
S G
SG
Phillips
N J
NJ
Brunt
E M
EM
D002839:Chromans / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D017093:Liver Failure / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008875:Middle Aged; D013844:Thiazoles / Q000009:adverse effects*; D045162:Thiazolidinediones; D000077288:Troglitazone
D002839:Chromans; D007004:Hypoglycemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; D000077288:Troglitazone