title: Hepatotoxicity due to troglitazone: report of two cases and review of adverse events reported to the United States Food and Drug Administration.
abstract: Two patients (a 48-year-old woman and a 62-year-old man) developed clinical and laboratory signs of hepatotoxicity due to troglitazone (Rezulin), a thiazolidinedione used in treatment of diabetes mellitus. There was no clear clinical evidence of drug allergy, although the woman experienced colitis before the onset of recognized hepatotoxicity. Liver biopsies showed bridging necrosis and fibrosis in the woman and hepatitis with granuloma formation in the man. The abnormalities in liver chemistries resolved promptly upon cessation of the drug. Cases involving 46 patients reported to the United States Food and Drug Administration are also reviewed. Troglitazone is a useful new oral antihyperglycemic agent, but in about 1.9% of patients hepatotoxicity has occurred, which may be severe and even fatal. Frequent monitoring of serum liver chemistries in patients taking the drug is essential.
authors.affiliation: Department of Medicine, The Liver, Biliary, Pancreatic Center of UMASS Memorial Health Care, Worcester, Massachusetts 01655, USA.
authors.forename: J
authors.initials: J
authors.lastname: Kohlroser
authors.forename: J
authors.initials: J
authors.lastname: Mathai
authors.forename: J
authors.initials: J
authors.lastname: Reichheld
authors.forename: B F
authors.initials: BF
authors.lastname: Banner
authors.forename: H L
authors.initials: HL
authors.lastname: Bonkovsky
mesh_terms: D002839:Chromans / Q000009:adverse effects* / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D017093:Liver Failure / Q000139:chemically induced / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013844:Thiazoles / Q000009:adverse effects* / Q000627:therapeutic use; D045162:Thiazolidinediones; D000077288:Troglitazone
chemical_list: D002839:Chromans; D007004:Hypoglycemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; D000077288:Troglitazone