title: Acute oxcarbazepine-induced hepatotoxicity in a patient susceptible to developing drug-induced liver injury.
abstract: Oxcarbazepine (OXC) is generally accepted as a drug without risk of severe drug-induced hepatotoxicity, but according to recently reported pharmacovigilance data this statement has been challenged. However, in the literature there have been no reports of acute OXC-induced hepatotoxicity without systemic manifestations of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome. We present a female with seizures one month after delivery who had borderline elevated liver enzymes prior to the initiation of OXC treatment. Two weeks after introducing OXC, highly elevated liver enzymes were found. After discontinuation of OXC the enzymes continued to rise for another week, and afterward gradually decreased. The causal relationship with OXC intake was determined to be highly probable. Two years later, the transitory elevation of liver enzymes was observed during the treatment of acute tonsilopharingitis with amoxicillin + clavulanic acid. The repeated elevation of liver enzymes related to use of different drugs might indicate patients susceptibility for drug induced liver injuries. We suggest that monitoring of liver function tests would be clinically rational for early detection of acute OXC-induced liver hepatotoxicity in the patients with clinical and/or laboratory features which might be interpreted as possible risk factors of the increased susceptibility to drug induced liver injuries.
authors.affiliation: University of Zagreb, "Sveti Duh" University Hospital, University Department of Neurology, Zagreb, Croatia. mplanjarprvan@net.hr
authors.forename: Miljenka
authors.initials: M
authors.lastname: Planjar-Prvan
authors.forename: Ana
authors.initials: A
authors.lastname: Bielen
authors.forename: Ana
authors.initials: A
authors.lastname: Sruk
authors.forename: Marinko
authors.initials: M
authors.lastname: Marusić
authors.forename: Ivan
authors.initials: I
authors.lastname: Bielen
mesh_terms: D000166:Acridines / Q000494:pharmacology; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000494:pharmacology; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000517:prevention & control*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008107:Liver Diseases / Q000175:diagnosis; D008111:Liver Function Tests; D008956:Models, Chemical; D000078330:Oxcarbazepine; D049590:Postpartum Period; D011247:Pregnancy; D012640:Seizures / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors; D055815:Young Adult
chemical_list: D000166:Acridines; D002220:Carbamazepine; C011633:acridan; D000078330:Oxcarbazepine