Fenofibrate-induced acute cholestatic hepatitis.
Fenofibrate-induced acute or chronic hepatitis is rare, and only 11 reports from French, Italian or Spanish literature have been published up to date. We report a case of fenofibrate-induced acute cholestatic hepatitis. To the best of our knowledge, this is the first one reported in Taiwan. A 61-year-old man developed acute cholestatic hepatitis after taking fenofibrate 100 mg tid for 10 days. Laboratory profile on admission showed serum total bilirubin 9.3 mg/dL, direct bilirubin 2.7 mg/dL, alanine aminotransferase 249 IU/L, aspartate aminotransferase 259 IU/L, alkaline phosphatase 259 IU/L, and gamma-glutamyl transpeptidase 1014 IU/L. Pathology proved hepatocanalicular cholestasis in liver. Fenofibrate was discontinued immediately. His clinical manifestations and liver function tests improved gradually and returned to nearly normal in 2 months. We suggest that liver function tests, including total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyl transpeptidase, be checked at least 2 weeks after taking the drug and that serum aminotransferase be monitored every 3 months during the first 12 months of therapy. Treatment should be discontinued if alanine aminotransferase values increase by more than 100 IU/L.
Ho
Chiu-Yung
CY
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Kuo
Tzong-Haur
TH
Chen
Tseng-Shing
TS
Tsay
Shyh-Haw
SH
Chang
Full-Young
FY
Lee
Shou-Dong
SD
D000208:Acute Disease; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002779:Cholestasis / Q000139:chemically induced*; D011345:Fenofibrate / Q000009:adverse effects*; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
D000960:Hypolipidemic Agents; D011345:Fenofibrate