title: Agomelatine-induced liver injury in a patient with choledocholithiasis.
abstract: OBJECTIVE
  A case of agomelatine-induced hepatotoxicity is described in a 47-year female patient who has received the drug, 25 mg/day, for 4 months, for the treatment of depression.
  
  
  METHODS
  The patient was admitted to the Department of Gastroenterology because of fatigue and nausea, with concomitant elevation of alanine aminotransferase (ALT), 550 U/L, and asparagine aminotransferase (AST), 300 U/L.
  
  
  RESULTS
  Liver biopsy showed diffuse lymphocyte infiltration in the dilated portal spaces without lesion of hepatic lobules. Several weeks after stopping agomelatine, the liver enzymes returned to normal. Subsequently, small gallstones in common bile duct were detected and removed by the endoscopic sphincterotomy.
  
  
  CONCLUSIONS
  It is hypothesized that choledocholithiasis could theoretically increase a risk of developing agomelatine-induced hepatotoxicity in this patient. Any pre-existing liver disease should be a contraindication for treatment with agomelatine.
authors.affiliation: 1Department of Gastroenterology,Human Nutrition and Internal Diseases,Poznan University of Medical Sciences,Poznan,Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Eder
authors.affiliation: 2Department of Adult Psychiatry,Poznan University of Medical Sciences,Poznan,Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Permoda-Osip
authors.affiliation: 3Department of Clinical Pathomorphology,Poznan University of Medical Sciences,Poznan,Poland.
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Majewski
authors.affiliation: 1Department of Gastroenterology,Human Nutrition and Internal Diseases,Poznan University of Medical Sciences,Poznan,Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Linke
authors.affiliation: 2Department of Adult Psychiatry,Poznan University of Medical Sciences,Poznan,Poland.
authors.forename: Janusz K
authors.initials: JK
authors.lastname: Rybakowski
mesh_terms: D000081:Acetamides / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000150:complications*; D042883:Choledocholithiasis / Q000150:complications*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D008875:Middle Aged; D009281:Naphthalenes
chemical_list: D000081:Acetamides; D006993:Hypnotics and Sedatives; C084711:agomelatine; D009281:Naphthalenes
keywords: hepatotoxicity