title: Selective estrogen receptor modulator raloxifene-associated aggravation of nonalcoholic steatohepatitis.
abstract: A 53-year-old postmenopausal woman, who had a family history of cryptogenic liver cirrhosis, was diagnosed with osteoporosis, and started on the selective estrogen receptor modulator (SERM) raloxifene 60 mg/day orally. She developed marked liver dysfunction. Her body mass index (BMI) was 26.5. Her blood chemistry indicated AST 342 IU/L, ALT 356 IU/L, and hyaluronic acid 255 ng/mL. An oral glucose tolerance test showed impaired glucose tolerance with marked insulin resistance. Histologically, we diagnosed this case as having pre-cirrhotic nonalcoholic steatohepatitis (NASH). This is the first histologically confirmed case of NASH that was aggravated by raloxifene.
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan. ttakamura@m-kanazawa.jp <ttakamura@m-kanazawa.jp>
authors.forename: Toshinari
authors.initials: T
authors.lastname: Takamura
authors.forename: Akiko
authors.initials: A
authors.lastname: Shimizu
authors.forename: Takuya
authors.initials: T
authors.lastname: Komura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Minato
authors.forename: Eiki
authors.initials: E
authors.lastname: Matsushita
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D056486:Chemical and Drug Induced Liver Injury / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005234:Fatty Liver / Q000139:chemically induced* / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D018149:Glucose Intolerance / Q000139:chemically induced; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000201:enzymology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000209:etiology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D020849:Raloxifene Hydrochloride / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects* / Q000627:therapeutic use; D012720:Severity of Illness Index
chemical_list: D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase