Annals
Established in 1927 by the American College of Physicians
:
Advanced search
 
box Article
 arrow  Correction
space
 arrow  Table of Contents                
space
 arrow  Full Text of this article
space
 arrow  PDF of this article
(PDFs free after 6 months)
space
 arrow  Summary for Patients
space
 arrow  Figures/Tables List
space
 arrow  Related articles in Annals
space
box Services
 arrow  Send comment/rapid response letter
space
 arrow  Notify a friend about this article
space
 arrow  Alert me when this article is cited
space
 arrow  Add to Personal Archive
space
 arrow  Download to Citation Manager
space
 arrow  ACP Search                        
space
 arrow  Get Permissions
space
box Google Scholar
 arrow  Search for Related Content
space
box PubMed
Articles in PubMed by Author:
  arrow  Al-Salman, J.
space
  arrow  Mittal, M.
space
 arrow  Related Articles in PubMed
space
 arrow  PubMed Citation
space
 arrow  PubMed
space

BRIEF COMMUNICATION

Hepatocellular Injury in a Patient Receiving Rosiglitazone: A Case Report

right arrow Jameela Al-Salman, MD; Heider Arjomand, MD; David G. Kemp, MD; and Manoj Mittal, MD

18 January 2000 | Volume 132 Issue 2 | Pages 121-124

Background: Rosiglitazone maleate (Avandia, SmithKline Beecham, Philadelphia, Pennsylvania) is a new oral hypoglycemic agent approved for the treatment of type 2 diabetes. It acts primarily by increasing insulin sensitivity. In controlled trials, there has been no evidence of rosiglitazone-induced hepatocellular injury.

Objective: To report a case of hepatocellular injury in a patient receiving rosiglitazone.

Design: Case report.

Setting: Community teaching hospital.

Patient: 61-year-old man receiving rosiglitazone, 4 mg/d for 2 weeks.

Intervention: Discontinuation of rosiglitazone therapy.

Measurements: Clinical evaluation and assessment of liver function test results were done daily during hospitalization and periodically after discharge. The outpatient record was also reviewed.

Results: After receiving rosiglitazone for 2 weeks, the patient presented with anorexia, vomiting, and abdominal pain. Liver function tests revealed severe hepatocellular injury. Discontinuation of rosiglitazone therapy led to rapid improvement of liver function and resolution of symptoms.

Conclusion: Rosiglitazone may be associated with hepatocellular injury. We believe that patients receiving rosiglitazone should have liver enzyme levels monitored earlier and more frequently than initially recommended.

Author and Article Information
space

From Easton Hospital, MCP-Hahnemann University, Easton, Pennsylvania.

Requests for Reprints: Manoj K. Mittal, MD, Division of Gastroenterology, Easton Hospital, 250 South 21st Street, Easton, PA 18042. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

Current Author Addresses: Drs. Al-Salman, Arjomand, and Kemp: Department of Medicine, Easton Hospital, 250 South 21st Street, Easton, PA 18042.

Dr. Mittal: Division of Gastroenterology, Easton Hospital, 250 South 21st Street, Easton, PA 18042.

Author Contributions: Conception and design: J. Al-Salman, H. Arjomand.

Analysis and interpretation of data: J. Al-Salman, H. Arjomand, D.G. Kemp.

Drafting of the article: J. Al-Salman, H. Arjomand.

Critical revision of the article for important intellectual content: J. Al-Salman, H. Arjomand, D.G. Kemp.

Final approval of the article: J. Al-Salman, H. Arjomand, D.G. Kemp, M.K. Mittal.

Provision of study materials or patients: D.G. Kemp.

Administrative, technical, or logistic support: D.G. Kemp.

Collection and assembly of data: J. Al-Salman, H. Arjomand, D.G. Kemp.


Related articles in Annals:

Brief Communications
Hepatic Failure in a Patient Taking Rosiglitazone
Lisa M. Forman, David A. Simmons, AND Robert H. Diamond
Annals 2000 132: 118-121. [ABSTRACT][SUMMARY][Full Text]  

Summaries for Patients
Liver Injury in a Person Taking the Diabetes Drug Rosiglitazone
Annals 2000 132: 121. [Full Text]  

Letters
Correction: Liver Injury and Rosiglitazone
Annals 2000 133: 237. [Full Text]  

Letters
Rosiglitazone and Liver Failure
William L. Isley AND Julie C. Oki
Annals 2000 133: 393. [Full Text]  

Letters
Rosiglitazone and Liver Failure
Lisa M. Forman AND Robert H. Diamond
Annals 2000 133: 393-394. [Full Text]  

Letters
Rosiglitazone Toxicity
Ravi Sudhir Ravinuthala AND Uday Nori
Annals 2000 133: 658. [Full Text]  

Letters
Isolated Elevation of Alkaline Phosphatase Level Associated with Rosiglitazone
David M. Hachey, Michael P. O'Neil, AND Rex W. Force
Annals 2000 133: 752. [Full Text]  

Letters
Hepatocellular Injury in a Patient Receiving Pioglitazone
Kenji Maeda
Annals 2001 135: 306. [Full Text]  

Letters
Did This Drug Cause My Patient's Hepatitis?
Neil Kaplowitz, James H. Lewis, AND Paul B. Watkins
Annals 2003 138: 159. [Full Text]  



This article has been cited by other articles:


Home page
Diabetes CareHome page
K. G. Tolman, V. Fonseca, A. Dalpiaz, and M. H. Tan
Spectrum of Liver Disease in Type 2 Diabetes and Management of Patients With Diabetes and Liver Disease
Diabetes Care, March 1, 2007; 30(3): 734 - 743.
[Full Text] [PDF]


Home page
Am J Health Syst PharmHome page
H. A. Spiller and T. S. Sawyer
Toxicology of oral antidiabetic medications
Am. J. Health Syst. Pharm., May 15, 2006; 63(10): 929 - 938.
[Abstract] [Full Text] [PDF]


Home page
Toxicol SciHome page
M. A. Peraza, A. D. Burdick, H. E. Marin, F. J. Gonzalez, and J. M. Peters
The Toxicology of Ligands for Peroxisome Proliferator-Activated Receptors (PPAR)
Toxicol. Sci., April 1, 2006; 90(2): 269 - 295.
[Abstract] [Full Text] [PDF]


Home page
The Annals of PharmacotherapyHome page
T. R Marcy, M. L Britton, and S. M Blevins
Second-Generation Thiazolidinediones and Hepatotoxicity
Ann. Pharmacother., September 1, 2004; 38(9): 1419 - 1423.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
W. M. Lee
Drug-Induced Hepatotoxicity
N. Engl. J. Med., July 31, 2003; 349(5): 474 - 485.
[Full Text] [PDF]


Home page
Drug Metab. Dispos.Home page
J. Sahi, C. B. Black, G. A. Hamilton, X. Zheng, S. Jolley, K. A. Rose, D. Gilbert, E. L. LeCluyse, and M. W. Sinz
Comparative Effects of Thiazolidinediones on in Vitro P450 Enzyme Induction and Inhibition
Drug Metab. Dispos., April 1, 2003; 31(4): 439 - 446.
[Abstract] [Full Text] [PDF]


Home page
The Diabetes EducatorHome page
R. K. Campbell and J. White
Counseling Patients With Type 2 Diabetes and Insulin Resistance in the Outpatient Setting
The Diabetes Educator, November 1, 2002; 28(6): 938 - 957.
[PDF]


Home page
Hum Exp ToxicolHome page
J D Tugwood and C T Montague
Biology and toxicology of PPARg ligands
Human and Experimental Toxicology, August 1, 2002; 21(8): 429 - 437.
[Abstract] [PDF]


Home page
Diabetes CareHome page
H. E. Lebovitz, M. Kreider, and M. I. Freed
Evaluation of Liver Function in Type 2 Diabetic Patients During Clinical Trials: Evidence that rosiglitazone does not cause hepatic dysfunction
Diabetes Care, May 1, 2002; 25(5): 815 - 821.
[Abstract] [Full Text] [PDF]


Home page
ANN INTERN MEDHome page
A. A. Parulkar, M. L. Pendergrass, R. Granda-Ayala, T. R. Lee, and V. A. Fonseca
Nonhypoglycemic Effects of Thiazolidinediones
Ann Intern Med, January 2, 2001; 134(1): 61 - 71.
[Abstract] [Full Text] [PDF]


Home page
Diabetes CareHome page
M. J. Lenhard and W. B. Funk
Failure to Develop Hepatic Injury From Rosiglitazone in a Patient With a History of Troglitazone-Induced Hepatitis
Diabetes Care, January 1, 2001; 24(1): 168 - 169.
[Full Text]


Home page
Endocr. Rev.Home page
S. Matthaei, M. Stumvoll, M. Kellerer, and H.-U. Häring
Pathophysiology and Pharmacological Treatment of Insulin Resistance
Endocr. Rev., December 1, 2000; 21(6): 585 - 618.
[Abstract] [Full Text]


Home page
ANN INTERN MEDHome page
D. M. Hachey, M. P. O'Neil, and R. W. Force
Isolated Elevation of Alkaline Phosphatase Level Associated with Rosiglitazone
Ann Intern Med, November 7, 2000; 133(9): 752 - 752.
[Full Text] [PDF]


Home page
ANN INTERN MEDHome page
R. S. Ravinuthala and U. Nori
Rosiglitazone Toxicity
Ann Intern Med, October 17, 2000; 133(8): 658 - 658.
[Full Text] [PDF]


Home page
ANN INTERN MEDHome page
W. L. Isley and J. C. Oki
Rosiglitazone and Liver Failure
Ann Intern Med, September 5, 2000; 133(5): 393 - 393.
[Full Text] [PDF]


Home page
ANN INTERN MEDHome page
E. Arioglu, J. Duncan-Morin, N. Sebring, K. I. Rother, N. Gottlieb, J. Lieberman, D. Herion, D. E. Kleiner, J. Reynolds, A. Premkumar, et al.
Efficacy and Safety of Troglitazone in the Treatment of Lipodystrophy Syndromes
Ann Intern Med, August 15, 2000; 133(4): 263 - 274.
[Abstract] [Full Text] [PDF]


Home page
Journal of Pharmacy PracticeHome page
S. Campbell
Management of Type 2 Diabetes in the Geriatric Patient
Journal of Pharmacy Practice, August 1, 2000; 13(4): 263 - 276.
[Abstract] [PDF]


Home page
ANN INTERN MEDHome page
Correction: Liver Injury and Rosiglitazone
Ann Intern Med, August 1, 2000; 133(3): 237 - 237.
[Full Text] [PDF]


Home page
JWatch GastroenterologyHome page
Is Rosiglitazone Hepatotoxic, Too?
Journal Watch Gastroenterology, April 1, 2000; 2000(401): 18 - 18.
[Full Text]


Home page
JWatch GeneralHome page
Is Rosiglitazone Hepatotoxic, Too?
Journal Watch (General), February 1, 2000; 2000(201): 1 - 1.
[Full Text]




 Home | Current Issue | Past Issues | In the Clinic | ACP Journal Club | CME | Collections | Audio/Video | Mobile | Subscribe | Tools | Help | ACP Online 

Copyright © 2000 by the American College of Physicians.