title: Flupirtine-induced hepatic failure requiring orthotopic liver transplant.
abstract: We present the case of a 48-year-old otherwise healthy man who required an urgent liver transplant owing to acute liver failure after flupirtine treatment. After 3 months of daily flupirtine intake as treatment for pseudoradicular pain syndrome, he presented at our institution with signs of jaundice and hepatic encephalopathy. Laboratory results showed elevated liver transaminases, and the liver histopathology supported the assumed drug-induced liver injury. After listing him for an urgent liver transplant, he was given a liver graft from a 21-year-old man. Despite a rejection episode on day 11 after the surgery (which was successfully treated by steroid pulse therapy), the postoperative course was uneventful and the patient recovered completely. To the best of our knowledge, this is the first report of a liver transplant for acute liver failure after taking flupirtine.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charite Campus Virchow, Charite Campus Mitte, Universitatsmedizin Berlin, Germany. fritz.klein@charite.de
authors.forename: Fritz
authors.initials: F
authors.lastname: Klein
authors.forename: Matthias
authors.initials: M
authors.lastname: Glanemann
authors.forename: Birgit
authors.initials: B
authors.lastname: Rudolph
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
mesh_terms: D000631:Aminopyridines / Q000009:adverse effects*; D000700:Analgesics / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017093:Liver Failure / Q000139:chemically induced / Q000175:diagnosis / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D020551:Pulse Therapy, Drug; D013256:Steroids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000631:Aminopyridines; D000700:Analgesics; D007166:Immunosuppressive Agents; D013256:Steroids; C034161:flupirtine