title: Sitaxsentan-induced acute severe hepatitis treated with glucocorticoid therapy.
abstract: Endothelin receptor antagonists are commonly used in the treatment of pulmonary hypertension. Sitaxsentan, a selective endothelin A receptor blocker, induces a mild transaminitis in approximately 3% to 5% of patients, but rarely an acute severe hepatitis. A case involving a 61-year-old female with sitaxsentan-induced acute severe liver failure is presented. Depite withdrawal of therapy, her liver tests failed to improve. After six weeks of monitoring, the patient was administered high-dose corticosteroids, with a good clinical and biochemical response. While endothelin receptor antagonists are postulated to cause hepatitis by inhibition of a bile salt transporter pump, an immune-mediated or idiosyncratic mechanism should be considered.
authors.affiliation: Faculty of Medicine and Dentistry, University of Western Australia, Australia. marcus.chin@health.wa.gov.au
authors.forename: Marcus
authors.initials: M
authors.lastname: Chin
authors.forename: Robert D
authors.initials: RD
authors.lastname: Levy
authors.forename: Eric M
authors.initials: EM
authors.lastname: Yoshida
authors.forename: Michaeal F
authors.initials: MF
authors.lastname: Byrne
mesh_terms: D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy* / Q000209:etiology; D065128:Endothelin Receptor Antagonists; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy; D007555:Isoxazoles / Q000009:adverse effects* / Q000627:therapeutic use; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000188:drug therapy; D008875:Middle Aged; D017466:Receptors, Endothelin / Q000627:therapeutic use; D013876:Thiophenes / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D065128:Endothelin Receptor Antagonists; D005938:Glucocorticoids; D007555:Isoxazoles; D017466:Receptors, Endothelin; D013876:Thiophenes; C106276:sitaxsentan