Author/Authors :
Lou, Horng-Yuan Division of Gastroenterology and Hepatology - Department of Internal Medicine - Taipei Medical University Hospital - Taipei, Taiwan , Fang, Chia-Lang Department of Pathology - Taipei Medical University Hospital - Taipei, Taiwan , Fang, Sheng-Uei Division of Gastroenterology and Hepatology - Department of Internal Medicine - Taipei Medical University Hospital - Taipei, Taiwan , Tiong, Cheng Division of Gastroenterology and Hepatology - Department of Internal Medicine - Taipei Medical University Hospital - Taipei, Taiwan , Cheng, Yang-Chih Division of Gastroenterology and Hepatology - Department of Internal Medicine - Taipei Medical University Hospital - Taipei, Taiwan , Chang, Chun-Chao Division of Gastroenterology and Hepatology - Department of Internal Medicine - Taipei Medical University Hospital - Taipei, Taiwan
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.
