Clinical evaluation of liver injury in patients with acute ischemic brain stroke treated with edaravone.
OBJECTIVE
To elucidate the etiologic factors and features of liver injury in patients with acute ischemic brain stroke who were treated with edaravone and reported by their attending physicians to have developed serious liver injury.


METHODS
The present study investigated 123 patients with a verified episode of liver injury among 132 patients with serious liver injury that had been reported attributable to edaravone.


RESULTS
Ischemic and/or congestive liver (70.7%) were most predominant among the etiologic factors for liver injury, and edaravone-related liver injury accounted for 20.3% (25 patients). Evident liver injury (defined in the text) was found in 104 among 123 evaluated patients; 54 patients (51.9%) of the former subset showed severe liver injury (defined increases in serum aspartate and/or alanine aminotransferase levels of ≥1000 IU/L and/or serum total bilirubin levels of ≥5 mg/dL). Among 104 patients with evident liver injury, 65 showed recovery. Furthermore, 53 patients (51.0%) were complicated by renal disorders; all of these patients had ischemic and/or congestive liver, or severe infections.


CONCLUSIONS
Edaravone was considered to be etiologic for liver injury in approximately 20% of evaluated patients. When a patient treated with edaravone developed liver injury therefore an investigation not only on edaravone but also on other potential etiologic factors (e.g. ischemic liver, congestive liver, and infection) and the quick implementation of appropriate treatments, especially for infections, revealed possible reductions in the incidences of severe liver injury and of complications by renal disorders.
Department of Internal Medicine, Sangenjaya Hospital, Tokyo, Japan.
Masanori
M
Hirano