title: Daclatasvir and Asunaprevir Combination Therapy-induced Hepatitis and Cholecystitis with Coagulation Disorder due to Hypersensitivity Reactions.
abstract: A 70-year-old woman with chronic hepatitis C was admitted to our hospital due to liver injury, cholecystitis, and disseminated intravascular coagulation with a fever and skin rash. She had been on a combination regimen of daclatasvir and asunaprevir for 2 weeks of a 24-week regimen. Because of the symptoms, laboratory findings, results of a drug-induced lymphocyte stimulation test, and pathological findings of liver biopsy, we diagnosed her with drug-induced liver injury. Although daclatasvir and asunaprevir combination therapy is generally well-tolerated, some serious adverse effects have been reported. Our findings indicate that immunoallergic mechanisms were associated with daclatasvir and asunaprevir-induced liver injury.
authors.affiliation: Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Miyashima
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Honma
authors.forename: Koichiro
authors.initials: K
authors.lastname: Miyagawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Oe
authors.forename: Michio
authors.initials: M
authors.lastname: Senju
authors.forename: Michihiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hiura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Abe
authors.forename: Masaru
authors.initials: M
authors.lastname: Harada
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People; D002219:Carbamates; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000188:drug therapy*; D002764:Cholecystitis / Q000139:chemically induced* / Q000150:complications; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007546:Isoquinolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011759:Pyrrolidines; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives
chemical_list: D000998:Antiviral Agents; D002219:Carbamates; D007093:Imidazoles; D007546:Isoquinolines; D011759:Pyrrolidines; D013449:Sulfonamides; D014633:Valine; C549273:daclatasvir; C571889:asunaprevir