Efavirenz-Induced Vanishing Bile Duct Syndrome: A Case Report
| Autor: | Robin Dretler, Angela Shogbon Nwaesei, Pamela M. Moye-Dickerson |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Cyclopropanes
Male medicine.medical_specialty Efavirenz Anti-HIV Agents Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Emtricitabine Humans Medicine Pharmacology (medical) Cholestasis business.industry Vanishing bile duct syndrome Middle Aged medicine.disease Benzoxazines chemistry Adverse drug event Alkynes 030211 gastroenterology & hepatology Bile Ducts business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Pharmacy Practice. 34:319-324 |
| ISSN: | 1531-1937 0897-1900 |
| DOI: | 10.1177/0897190019868358 |
| Popis: | Background: Efavirenz (Sustiva®) is used for the treatment of human immunodeficiency virus (HIV) type 1 infection. Hepatoxicity is a known potential adverse drug event with efavirenz; however, to our knowledge, vanishing bile duct syndrome (VBDS), a type of liver injury, has not been reported with this therapy. Case Presentation: We report the case of a 48-year-old male with HIV and VBDS secondary to antiretroviral therapy. The patient was started on efavirenz, emtricitabine, and tenofovir disoproxil fumarate (Atripla®). Four weeks later, the patient presented with complaints of poor appetite, nausea with emesis, dark urine, and malaise. Labs obtained supported the diagnosis of acute hepatitis, and a liver biopsy confirmed a diagnosis of VBDS. The Naranjo adverse drug reaction probability scale showed that it was probable (score of 7) that the VBDS was related to drug therapy. Efavirenz was assessed to be the most likely cause of VBDS, end-stage liver disease, and the eventual need for liver transplantation. Conclusion: To our knowledge, this is the first reported case of probable efavirenz-induced VBDS in a patient living with HIV. Recognition and awareness of this adverse drug reaction by clinicians for quick diagnosis, discontinuation of therapy, and management are important in patients receiving this regimen. |
| Databáze: | OpenAIRE |
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