Hepatic Failure Related to Itraconazole Use Successfully Treated by Corticosteroids

authors:

avatar Horng-Yuan Lou 1 , avatar Chia-Lang Fang 1 , avatar Sheng-Uei Fang 1 , avatar Cheng Tiong 1 , avatar Yang-Chih Cheng 1 , avatar Chun-Chao Chang 2 , *

1) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital. 2) Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan
1) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital. 2) Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, chunchao@tmu.edu.tw, Taiwan
Hepatitis Monthly: Vol.11, issue 10; 843-846
article type: Case Report
received: February 24, 2011
accepted: August 8, 2011
DOI: https://doi.org/10.5812/kowsar.1735143X.755

how to cite: Lou H, Fang C, Fang S, Tiong C, Cheng Y, et al. Hepatic Failure Related to Itraconazole Use Successfully Treated by Corticosteroids. Hepat Mon. 2011;11(10): 843-846. https://doi.org/10.5812/kowsar.1735143X.755.

Abstract

Background: Itraconazole is believed to carry a low risk of hepatic toxicity owing to its low affinity for the human P-450 enzyme. Therefore, hepatic failure caused by itraconazole is exceedingly rare.
Objectives: We report the case of a 46-year-old woman who developed hepatic failure related to itraconazole that was administered for the treatment of onychomycosis. Her condition deteriorated after withdrawal of the drug, followed solely by supportive care initially.
Case Report: Treatment with corticosteroids was started 10 days after her admission, and her condition gradually improved. Unfortunately, her condition worsened when the dosage of corticosteroids was abruptly decreased. Ultimately, her condition improved with appropriate adjustments of corticosteroid dosage.
Discussion: We conclude that corticosteroid therapy may be effective for itraconazole-induced hepatitis, especially in those patients who do not respond to conservative treatment. Notably, any decrease in the dosage should be performed with caution. We also recommend that close monitoring of liver function is mandatory during the use of itraconazole.

  • Implication for health policy/practice/research/medical education:
    Corticosteroid treatment may be effective for itraconazole-induced hepatitis for those who do not response to conservative treatment.
  • Please cite this paper as:
    Lou HY, Fang CL, Fang SU, Tiong C, Cheng YC, Chang CC. Hepatic Failure Related to Itraconazole Use Successfully Treated by Corticosteroids. Hepat Mon. 2011;11(10):843-6. DOI:10.5812/kowsar.1735143X.755

© 2011 Kowsar M.P.Co. All rights reserved.

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