Pegvisomant-Induced Cholestatic Hepatitis in an Acromegalic Patient with UGT1A1 ⁎ 28 Mutation
| Autor: | Maria Susana Mallea-Gil, Ignacio Bernabeu, Adriana Spiraquis, Alejandra Avangina, Lourdes Loidi, Carolina Ballarino |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: | |
| Zdroj: | Case Reports in Endocrinology, Vol 2016 (2016) |
| Druh dokumentu: | article |
| ISSN: | 2090-6501 2090-651X |
| DOI: | 10.1155/2016/2087102 |
| Popis: | Pegvisomant (PEGv) is a growth hormone receptor antagonist approved for the treatment of acromegaly; one of its documented adverse effects is reversible elevation of hepatic enzymes. We report a 39-year-old male acromegalic patient with a pituitary macroadenoma who underwent transsphenoidal surgery. The patient’s condition improved but GH and IGF-I levels did not normalize; as a consequence, we first administered dopamine agonists and then somatostatin receptor ligands (SRLs) with poor response. PEGv 15 mg every other day was added to lanreotide 120 mg monthly. The patient developed a severe hepatitis five months after starting the combination therapy. Elevated ferritin, iron, and transferrin saturation suggested probable hepatitis due to haemochromatosis. We performed a liver biopsy which showed an acute cholestatic hepatitis consistent with toxic etiology. A heterozygous genotype UGT1A1⁎28 polymorphism associated with Gilbert’s syndrome was also found in this Argentine patient. The predominant clinical presentation resembled an acute cholestatic hepatitis associated with severe hemosiderosis, a different and new pattern of PEGv hepatotoxicity. |
| Databáze: | Directory of Open Access Journals |
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