Hepatocellular injury in a patient receiving rosiglitazone. A case report.
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.
Al-Salman
J
J
Department of Medicine, Easton Hospital, MCP-Hahnemann University, Pennsylvania 18042, USA.
Arjomand
H
H
Kemp
D G
DG
Mittal
M
M
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
D007004:Hypoglycemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; D000077154:Rosiglitazone