title: Propafenone hepatotoxicity: report of a new case and review of the literature.
abstract: Propafenone is a class Ic antiarrhythmic drug. It is a beta-adrenergic blocker that causes bradycardia and bronchospasm. It is metabolized primarily in the liver. Its bioavailability and plasma concentration differ among patients under long-term therapy. They are genetically determined by the hepatic cytochrome P-450 2D6. Hepatic toxicity is highly uncommon. To date, only eight patients were reported in the reviewed world literature. In this article, one new case will be reported emphasizing the importance of medication history taking in patients presenting with new-onset liver enzymes abnormalities.
authors.affiliation: Department of Internal Medicine, Divisions of Gastroenterology and Hepatology, and Cardiology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Lara B
authors.initials: LB
authors.lastname: Younan
authors.forename: Kassem A
authors.initials: KA
authors.lastname: Barada
authors.forename: Walid G
authors.initials: WG
authors.lastname: Faraj
authors.forename: Ayman N
authors.initials: AN
authors.lastname: Tawil
authors.forename: Mark N
authors.initials: MN
authors.lastname: Jabbour
authors.forename: Maurice Y
authors.initials: MY
authors.lastname: Khoury
authors.forename: Nadim Mw
authors.initials: NM
authors.lastname: El-Majzoub
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Eloubeidi
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001707:Biopsy, Needle; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000473:pathology; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D011405:Propafenone / Q000009:adverse effects* / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone
references.citation: Ann Pharmacother. 1992 Jul-Aug;26(7-8):926-8
references.pmid: 1354511
references.citation: Clin Pharmacol Ther. 1981 Aug;30(2):239-45
references.pmid: 7249508
references.citation: Eur Heart J. 1987 Mar;8 Suppl A:27-32
references.pmid: 3556176
references.citation: Dig Dis Sci. 2003 Feb;48(2):354-7
references.pmid: 12643615
references.citation: Gastroenterology. 1993 May;104(5):1524-6
references.pmid: 8482464
references.citation: Dtsch Med Wochenschr. 1984 Oct 5;109(40):1525-7
references.pmid: 6206993
references.citation: Am J Cardiol. 1984 Nov 14;54(9):9D-12D
references.pmid: 6496371
references.citation: N Engl J Med. 1990 Feb 22;322(8):518-25
references.pmid: 2405273
references.citation: Z Gastroenterol. 1981 Oct;19(10):673-9
references.pmid: 6117993