Acute Liver Injury during Co-treatment with Levetiracetam and Temozolomide
Journal Title: Liver Research – Open Journal - Year 2015, Vol 1, Issue 1
Abstract
Drug-induced liver injury (DILI) accounts for approximately 10 percent of all cases of acute hepatitis. The patterns of acute injury include any form of hepatic injury, but the most common problems are cholestasis, hepatocellular damage, or a mixed type. DILI is often reversible, and discontinuation of the offending agent usually results in a complete recovery; however, some cases may lead to chronic liver injury, cirrhosis, and even death. Temozolomide (TMZ) is an alkylating, anti-neoplastic agent used for the treatment of refractory anaplastic astrocytoma, newly-diagnosed Glioblastoma multiforme (GBM) and metastatic melanoma. Levetiracetam (LEV) is an established second-generation antiepileptic drug and is most commonly approved as adjunctive treatment of partial-onset seizures with or without secondary generalization. When administered separately each of these drugs is considered to be relatively safe and only few cases of severe liver injury can be found throughout the literature; however, LEV and TMZ are commonly used together in the treatment of brain malignancies. We report three patients who presented with jaundice during treatment with TMZ and LEV, and propose a mechanism for liver sensitization by LEV for TMZ-induced injury.
Authors and Affiliations
Meir Mizrahi
Iron and Copper Toxicity in Rat Liver: A Kinetic and Holistic Overview
Iron (Fe) and copper (Cu) overloads in rats showed a dose and time dependent metal accumulation in liver with its associated toxicity. The increased contents of the transition metals markedly enhanced the endogenous free...
Metastatic Liver Disease - Presenting as Multiple Hepatic Cysts
A 59 year-old woman with a history of successfully treated Hepatitis-C, Systemic Lupus Erythematosus, and a remote history of melanoma of the scalp presented to our center for evaluation of abdominal pain, nausea, vomiti...
Acute Variceal Bleeding in Patients with Liver Cirrhosis with and without Diabetes
Objectives: To study the effect of diabetes mellitus on presentations, course, and outcome of acute variceal bleeding in cirrhotic patients. Methods: We compared 2 matched groups of patients, a diabetic group and non-dia...
The Prescribers’ Dilemma: Treatment of Hepatitis C Infection for Medicaid Insured Patients in United States
Introduction of Direct Acting Antivirals (DAA) to Hepatitis C Virus (HCV) treatment armamentarium has offered a great boost to the providers’ confidence to safely and effectively treat HCV infection in the majority of pa...
Magnetic Resonance Elastography Comes of Age
Clinicians are always in search of a less invasive method of diagnosing and assessing a patient. Patients with liver cirrhosis are no exception. Liver cirrhosis is the end stage of many liver pathologies and knowledge of...