Tamoxifen-associated steatohepatitis - report of three cases

Pinto, Helena; Baptista, António M.; Camilo, M.; Costa, Eduardo Bruno de; Valente, A; Moura, Miguel Carneiro de

doi:10.1016/0168-8278(95)80316-5

Cited by 88 publications

(28 citation statements)

References 19 publications

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“…Resolution of transaminase elevations were observed by other authors who noted resolution of transaminase levels 2 months to 32 months after discontinuation of tamoxifen. 6,7,9,11 Cirrhosis is a rare complication of tamoxifen therapy. We noted 2 patients with biopsy-documented cirrhosis in 806 patients who took tamoxifen.…”

Section: Discussionmentioning

confidence: 99%

“…All 24 patients who had NASH, including 7 patients who were diagnosed by biopsy, had elevations of (6) transaminases to >2 times the normal limit on 2 occasions. The aspartate aminotransferase (AST) level was >2 times normal in 9 patients, the alanine aminotransferase (ALT) level was >2 times normal in 2 patients, and both transaminase levels were >2 times normal in 13 patients.…”

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confidence: 99%

“…Early case reports and small series documented NASH in patients who received tamoxifen. [5][6][7][8][9][10][11][12][13][14] Imaging studies documented the development of fatty liver in approximately 33% of patients who took tamoxifen. [15][16][17][18][19][20][21][22][23][24][25][26] More sophisticated reports explored the relation between elevated transaminases and the diagnosis of steatohepatitis in patients with breast cancer 27,28 and the effects of tamoxifen in patients with pre-existing steatohepatitis.…”

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confidence: 99%

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The association of nonalcoholic steatohepatitis and tamoxifen in patients with breast cancer

Saphner

Triest-Robertson

et al. 2009

Cancer

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BACKGROUND:Nonalcoholic steatohepatitis (NASH) is a form of liver damage that can progress to cirrhosis. NASH is associated with obesity and diabetes. The condition also may be associated with some medications, including tamoxifen. Early case reports and small series have documented NASH in patients who received tamoxifen.METHODS:The records of patients registered in the St. Vincent Hospital Cancer Registry of Green Bay Wisconsin from January 1, 1992 to December 31, 2000 were reviewed.RESULTS:In total, 1105 patients with breast cancer were evaluated for NASH, and 24 cases of NASH were documented (2.2%). Seven patients had NASH before their diagnosis of breast cancer, and 17 patients developed NASH after their diagnosis of breast cancer. In multivariate analysis, the factors associated with NASH were tamoxifen use (odds ratio [OR], 8.2; 95% confidence interval [CI], 1.06‐63.72), body mass index (BMI) (OR, 1.13; 95% CI, 1.06‐1.20), and age (OR, 95% CI, 0.91‐0.99). NASH improved after tamoxifen was stopped. After discontinuation of tamoxifen, transaminase levels returned to normal in 14 of 16 patients.CONCLUSIONS:NASH was present in 24 of 1105 patients with breast cancer (2.2%). Seven patients had NASH before they were diagnosed with breast cancer, and 17 patients developed NASH after their diagnosis. NASH was associated with the use of tamoxifen and improved when tamoxifen was stopped. Cancer 2009. © 2009 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

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The association of nonalcoholic steatohepatitis and tamoxifen in patients with breast cancer

Saphner

Triest-Robertson

et al. 2009

Cancer

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“…In addition, an association with lipodystrophy has been observed although the exact mechanism is not clear. 67,68 Other noted associations include peroxisomal diseases, 69 mitochondrialopathies, [70][71][72][73] Weber-Christian disease, 74 Mauriac Syndrome, 75 Madelung's lipomatosis, 76 Wilson's Disease, 77 industrial solvent exposure, [78][79][80] medications 81 (amiodarone, 82 tamoxifen, 83,84 nucleoside analogues, 85 and methotrexate 86 ), celiac disease, 87 and abetalipoproteinemia. 88 Many of these disorders have in common either abnormal fat metabolism and/or mitochondrial injury or dysfunction.…”

Section: Clinical Aspectsmentioning

confidence: 99%

Nonalcoholic Steatohepatitis: Summary of An Aasld Single Topic Conference

2003

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“…These studies may further promote adjuvant tamoxifen, as 5-year treatment of tamoxifen for breast cancer undoubtedly outweighs the risks of the adverse effects. However, it was reported that rapidly progressive hepatic steatosis among nonobese nondiabetic breast cancer patients treated with tamoxifen was known to induce NASH and liver cirrhosis on rare occasions (8,(14)(15)(16)(17). The frequency of progressive hepatic steatosis had increased to 36% (18,19), and more than ten patients in our clinic were shown by liver biopsy to have tamoxifeninduced NASH.…”

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confidence: 99%