title: Hepatocellular injury in a patient receiving rosiglitazone. A case report.
abstract: BACKGROUND
  Rosiglitazone maleate (Avandia, SmithKline Beecham, Philadelphia, Pennsylvania) is a new oral hypoglycemic agent approved for the treatment of type 2 diabetes. It acts primarily by increasing insulin sensitivity. In controlled trials, there has been no evidence of rosiglitazone-induced hepatocellular injury.
  
  
  OBJECTIVE
  To report a case of hepatocellular injury in a patient receiving rosiglitazone.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Community teaching hospital.
  
  
  METHODS
  61-year-old man receiving rosiglitazone, 4 mg/d for 2 weeks.
  
  
  METHODS
  Discontinuation of rosiglitazone therapy.
  
  
  METHODS
  Clinical evaluation and assessment of liver function test results were done daily during hospitalization and periodically after discharge. The outpatient record was also reviewed.
  
  
  RESULTS
  After receiving rosiglitazone for 2 weeks, the patient presented with anorexia, vomiting, and abdominal pain. Liver function tests revealed severe hepatocellular injury. Discontinuation of rosiglitazone therapy led to rapid improvement of liver function and resolution of symptoms.
  
  
  CONCLUSIONS
  Rosiglitazone may be associated with hepatocellular injury. We believe that patients receiving rosiglitazone should have liver enzyme levels monitored earlier and more frequently than initially recommended.
authors.affiliation: Department of Medicine, Easton Hospital, MCP-Hahnemann University, Pennsylvania 18042, USA.
authors.forename: J
authors.initials: J
authors.lastname: Al-Salman
authors.forename: H
authors.initials: H
authors.lastname: Arjomand
authors.forename: D G
authors.initials: DG
authors.lastname: Kemp
authors.forename: M
authors.initials: M
authors.lastname: Mittal
mesh_terms: D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008099:Liver / Q000201:enzymology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D000077154:Rosiglitazone; D013844:Thiazoles / Q000009:adverse effects*; D045162:Thiazolidinediones
chemical_list: D007004:Hypoglycemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; D000077154:Rosiglitazone