title: Unintentional rechallenge resulting in a causative relationship between ketoconazole and acute liver injury.
abstract: We present the case of a female patient in whom acute overt hepatitis developed after 60 days of ketoconazole administration (200 mg/day). A prompt renewed hepatic injury 48 hours after an unintentional rechallenge 30 months later provided definitive evidence for a causative relationship between ketoconazole and acute liver injury. Histological examination revealed acute hepatitis with bridging hepatic necrosis. Clinicians should be aware of this cause and effect relationship between ketoconazole and acute liver injury, which can result in prompt severe acute liver injury after rechallenge.
authors.affiliation: Liver Research Unit, Chang-Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: R N
authors.initials: RN
authors.lastname: Chien
authors.forename: I S
authors.initials: IS
authors.lastname: Sheen
authors.forename: Y F
authors.initials: YF
authors.lastname: Liaw
mesh_terms: D000208:Acute Disease; D000935:Antifungal Agents / Q000009:adverse effects*; D001707:Biopsy, Needle / Q000379:methods; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D007654:Ketoconazole / Q000009:adverse effects*; D008099:Liver / Q000473:pathology*; D008875:Middle Aged; D009336:Necrosis; D012008:Recurrence
chemical_list: D000935:Antifungal Agents; D007654:Ketoconazole