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BRIEF COMMUNICATION

Troglitazone-Induced Hepatic Failure Leading to Liver Transplantation: A Case Report

right arrow Brent A. Neuschwander-Tetri, MD; William L. Isley, MD; Julie C. Oki, PharmD; Sanjay Ramrakhiani, MD; Stella G. Quiason, MD; Nancy J. Phillips, MD; and Elizabeth M. Brunt, MD

1 July 1998 | Volume 129 Issue 1 | Pages 38-41

Background: Troglitazone is a new drug for the treatment of type 2 diabetes. Although mild liver injury occurred in 1.9% of participants in controlled trials, the U.S. Food and Drug Administration has received reports of five postmarketing cases of severe liver disease that resulted in death or liver transplantation.

Objective: To report the clinical and histopathologic characteristics of a patient with troglitazone-associated severe liver injury leading to transplantation.

Design: Case report.

Setting: Two university hospitals.

Patient: A 55-year-old woman taking troglitazone, 400 mg/d, and insulin, 120 U/d.

Intervention: Discontinuation of troglitazone therapy, pretransplantation liver biopsy, and liver transplantation.

Results: Early nonspecific symptoms were attributed to other causes and were not evaluated. After the patient had used troglitazone for 3.5 months, massive loss of liver parenchyma and symptoms of liver failure developed, necessitating liver transplantation.

Conclusion: Troglitazone may cause subfulminant liver failure.


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Brief Communications
Two Cases of Severe Clinical and Histologic Hepatotoxicity Associated with Troglitazone
Norman Gitlin, Neil L. Julie, Charles L. Spurr, Kie N. Lim, AND Herbert M. Juarbe
Annals 1998 129: 36-38. [Full Text]  

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Troglitazone-Associated Hepatic Failure
Robert I. Misbin
Annals 1999 130: 330. [Full Text]  

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Troglitazone-Associated Hepatic Failure
Brent A. Neuschwander-Tetri, William L. Isley, AND Julie C. Oki
Annals 1999 130: 330. [Full Text]  



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