Hepatitis during chloroguanide prophylaxis.
OBJECTIVE
To describe a case of severe hepatitis that we attribute to the use of chloroguanide.


METHODS
A patient was admitted with fever and jaundice. This man had recently returned from Indonesia and was still using chloroguanide 200 mg once daily for 6 weeks. Evaluation of the liver function test results was consistent with cholestatic liver disease (alkaline phosphatase 158 U/L, aspartate aminotransferase 33 U/L, alanine aminotransferase 58 U/L increasing up to 183 U/L, gamma-glutamyl transferase 96 U/L). This condition was thought to be caused by chloroguanide. A biopsy of the liver indicated drug-induced hepatitis.


CONCLUSIONS
To our knowledge, this is the first report in the literature of cholestatic hepatitis associated with chloroguanide prophylaxis. In our patient, chloroguanide-induced hepatotoxicity can be considered as a combined allergic and idiosyncratic manifestation.


CONCLUSIONS
This case shows that it is possible to develop drug-induced hepatitis with considerable morbidity while taking chloroguanide prophylaxis.
Oostweegel
L M
LM
Department of Pharmacy and Pharmacology, Slotervaart Hospital/Netherlands Cancer Institute, Slotervaart Hospital, Amsterdam, The Netherlands.
Beijnen
J H
JH
Mulder
J W
JW
D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D006801:Humans; D008288:Malaria / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D002727:Proguanil / Q000009:adverse effects* / Q000627:therapeutic use
D000962:Antimalarials; D002727:Proguanil