title: Valproic acid related idiosyncratic drug induced hepatotoxicity in a glioblastoma patient treated with temozolomide.
abstract: Glioblastoma patients undergoing treatment with surgery followed by radiation and temozolomide chemotherapy often develop a state of immunosuppression and are at risk for opportunistic infections and reactivation of hepatitis and herpes viruses. We report the case of a 48-year-old glioblastoma patient who developed acute cholestatic hepatitis with hepatic failure during adjuvant treatment with temozolomide and the integrin inhibitor cilengitide. A viral hepatitis was excluded and valproic acid treatment was stopped. Upon normalisation of the liver tests, temozolomide treatment was resumed without perturbation of the liver tests. Valproic acid related idiosyncratic drug induced hepatotoxicity should be considered as a differential diagnosis in glioblastoma patients undergoing adjuvant therapy.
authors.forename: Bart
authors.initials: B
authors.lastname: Neyns
authors.forename: Anne
authors.initials: A
authors.lastname: Hoorens
authors.forename: Roger
authors.initials: R
authors.lastname: Stupp
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002779:Cholestasis / Q000139:chemically induced; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005909:Glioblastoma / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D017093:Liver Failure / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D000077204:Temozolomide; D014635:Valproic Acid / Q000009:adverse effects*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014635:Valproic Acid; D003606:Dacarbazine; D000077204:Temozolomide