Fulminant hepatic failure associated with aplastic anaemia after treatment with danazol. Case report

Nakajima, Toshiaki; Mizushima, N.; Matsuda, Hiroko; Matsumoto, Masako; Tamakoshi, Katsutoshi; Ishii, Hiroshi; Morioka, Satoshi; Kanai, Koichi; Ikeda, Yasuhiko; Terao, T.

doi:10.1111/j.1471-0528.1986.tb08029.x

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…4 Only one case of fulminant hepatitis induced by danazol has been reported. 6 In that patient, 400 mg of danazol was prescribed for endometriosis, and 12 days later, AST and ALT levels were elevated, to 2118 and 2049 IU/l, respectively. That patient recovered 3 months later, but developed aplastic anemia.…”

Section: Discussionmentioning

confidence: 99%

Fatal acute hepatic failure induced by danazol in a patient with endometriosis and aplastic anemia

Hayashi

Takahashi

Minami

et al. 2001

Journal of Gastroenterology

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We describe a 47-year-old woman with severe aplastic anemia with genital bleeding who developed acute severe hepatitis after the administration of danazol while she was receiving cyclosporin. She had been diagnosed with severe aplastic anemia 1 year previously and, while hospitalized, had received methyl prednisolone pulse therapy, which was not successful. She was then referred to our hospital. She was treated with antithymocyte globulin, cyclosporin, granulocyte colony-stimulating factor, and methyl prednisolone; a good response was achieved after 3 months of this therapy. Subsequently, oral administration of cyclosporin was continued, but she was readmitted to our hospital when pancytopenia gradually developed and the genital bleeding recurred. Danazol was administered for pancytopenia and endometriosis. Four days after the first administration of danazol, epigastric pain occurred, and the danazol was stopped. Eighteen days after the first danazol administration, very severe hepatic injury occurred abruptly. The patient died of hepatic failure. Postmortem examination revealed centrilobular massive necrosis of the liver. Danazol was implicated as the agent responsible for causing the hepatic failure. Drug interactions between danazol and cyclosporin may cause adverse effects.

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Section: Discussionmentioning

confidence: 99%

Fatal acute hepatic failure induced by danazol in a patient with endometriosis and aplastic anemia

Hayashi

Takahashi

Minami

et al. 2001

Journal of Gastroenterology

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Steroids and Other Hormones

Zimmerman¹,

Ishak²

1996

Handbook of Experimental Pharmacology

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Liver Damage Induced by Danazol

et al. 1994

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Danazol, which is a derivative of 17 a-ethinyltestosterone, is a synthetic steroid that suppresses ovarian function, reducing gonadotropin-releasing hormone (GnRH) secretion and inhibiting luteinising hormone (LH) and follicle-stimulating hormone (FSH), in addition to causing low, non-cyclic serum estradiol levels.As it inhibits gonadotropic function, danazol is frequently used in the treatment of endometriosis, [1,2] menorrhagia, gynaecomastia, hereditary angioedema[3] and fibrocystic mastopathy)4]Danazol was recently used to treat systemic lupus erythematosus,[S] idiopathic thrombocytopenic purpura[6] and AIDS-related thrombocytopenia[7] because it induces elevated antithrombin III levels)6] The effects are mainly mediated by sex hormone-binding globulin or androgen receptors.Hypoestrogenism may cause reduction of the breasts, flushes, irritability, anxious-depressive crises and behavioural changes, and androgenic and anabolic alterations (hirsutism, voice changes, acne, greasy skin, bulimia, and obesity). Side effects include muscle pains, and modified lipoprotein metabolism and liver functions; these effects are usually dose-dependent and tend to disappear after discontinuation of the drug)8]In 1980, Pearson and Zimmerman [9] reported 5 cases of abnormal liver function accompanied by slightly elevated transaminase levels. Only one of these patients presented with jaundice. Other authors have described rare cases of cholestasis,llO, II] diffuse liver damage,l12] hepatosplenic peliosis [13,14] and, occasionally, fulminant

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Fulminant hepatic failure associated with aplastic anaemia after treatment with danazol. Case report

Cited by 5 publications

References 10 publications

Fatal acute hepatic failure induced by danazol in a patient with endometriosis and aplastic anemia

Fatal acute hepatic failure induced by danazol in a patient with endometriosis and aplastic anemia

Steroids and Other Hormones

Liver Damage Induced by Danazol

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