Liver cirrhosis developed after ketoconazole‐induced acute hepatic injury

Abstract

We describe a previously healthy woman who developed liver cirrhosis as a sequela of acute hepatic injury that was induced by ketoconazole administration to treat onychomycosis. The initial presentation of the disease was of a typical acute hepatitis, characterized by nausea, anorexia, fatigue, and jaundice that developed during the administration of ketoconazole. Many other causes of hepatitis were absent in the patient. Even though the hepatic injury was gradually resolved for several months after cessation of the drug, the liver function was not completely restored. Six months after the onset of illness, a follow-up abdominal computed tomography and peritoneoscopic liver biopsy were performed. They revealed a marked reduction in the liver volume and a definite cirrhotic change, which persisted for more than 5 years. The case suggests that the administration of ketoconazole can cause liver cirrhosis through acute hepatic injury within a short time under certain circumstances.

Biomonitoring of the Genotoxic and Hepatotoxic Effects and Oxidative Stress Potentials of Itraconazole in Pregnant Rats

“…The observed histopathological alterations ranged from moderate to severe changes according to the dose used and to the length of the period of administration. The findings of many human and animal studies using several antifungal drugs were consistent with the present results (Adriaenssens et al., ; Liu et al., ; Chien et al., ; Kim et al., ). Histopathological changes such as inflammation and fibrosis were also observed in the liver of rats that received repeated doses of itraconazole (Norshahida, ).…”

Quantitative Evaluation of Pharmacokinetic Inhibition of CYP3A Substrates by Ketoconazole: A Simulation Study

“…In addition, investigators want to minimize exposure of healthy volunteers to KTZ because it may cause liver damage. 5,6 Although SD KTZ may be acceptable in some inhibition studies, the pharmacokinetic characteristics of the CYP3A substrate to be evaluated may influence the extent of inhibition by SD KTZ. For example, a study that evaluates a CYP3A substrate with a t 1/2 much longer than that of KTZ may require that additional MD KTZ be given following substrate administration.…”

Antidermatophyte and antioxidant activities of Nigella sativa alone and in combination with enilconazole in treatment of dermatophytosis in cattle

“…Some studies have reported clinical adverse effects after therapy with various systemic anti-fungal agents (Kim et al 2003;Figg et al 2010). Several case reports of mild-to-severe hepatic injury, including icteric and fatal cases, have been published (Kim et al 2003;Figg et al 2010). For instance, the adverse effects of griseofulvin include gastrointestinal symptoms, allergic reactions, photodermatitis, hepatic and renal dysfunctions.…”

“…In another study, one month after the last treatment with enilconazole, all animals were cured as assessed by clinical and mycological evaluation (Schepens and Spanoghe 1981). Some researchers reported that several systemic antifungal agents have adverse effects resulting in mild-tosevere hepatic injuries and renal syndromes in cats (Kim et al 2003;Figg et al 2010). Enilconazole is generally well tolerated but has also been associated with hypersalivation, anorexia, weight loss, emesis, idiopathic muscle weakness, and slightly elevated serum alanine aminotransferase (ALT) concentrations (Dejaham 1998;Hnilica and Medleau 2002 Nigella sativa (NS), an annual herbaceous plant of the Ranunculaceae, has been used traditionally in the Middle East, Northern Africa, Far East and Asia for the treatment of various diseases for over 2000 years (Phillips 1992).…”