Liver Damage Induced by Danazol

Abstract

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