586 Tamoxifen (TMX)-induced hepatotoxicity in breast cancer (BC) patients with pre-existing liver steatosis (LS). The role of glucose intolerance

Elefsiniotis, Ioannis; Pantazis, Konstantinos; Ilias, A.; Pallis, L.; Mariolis, Anargiros; Glynou, Irene; Kada, Hidemi; Moulakakis, Antonios

doi:10.1016/s0168-8278(04)90585-5

Cited by 6 publications

(8 citation statements)

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“…This is consistent with the findings of Elefsiniotis et al, who treated patients with steatosis diagnosed on CT scans with tamoxifen. 29 In that study, transaminase levels increased in 26 of 60 patients, but tamoxifen was ''well tolerated.'' NASH developed after tamoxifen use in 16 patients.…”

Section: Discussionmentioning

confidence: 88%

“…[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. 29 We retrospectively reviewed a population of patients with breast cancer to determine the frequency of NASH and the relation between NASH and the use of tamoxifen.…”

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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: 88%

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confidence: 99%

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

Saphner

Triest-Robertson

et al. 2009

Cancer

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“…HS is frequently encountered in many cancer patients, especially in patients with breast cancer in clinical oncology practice. Cases of NAFLD in patients with breast cancer have been usually reported secondary to TMX use [9][10][11][12][13][14][15][16][17][18]. In addition, cases developing cirrhosis have also been described [26].…”

Section: Discussionmentioning

confidence: 99%

“…In breast cancer patients, NAFLD has also been described as case reports due to tamoxifen (TMX) [9][10][11][12][13][14][15][16][17][18]. Although prevalence of HS has not been sufficiently studied, it has been reported in 30-38% of breast cancer patients receiving TMX [3,4].…”

Section: Introductionmentioning

confidence: 99%

A case–control study of non-alcoholic fatty liver disease in breast cancer

et al. 2007

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Hepatic steatosis, excluding patients with grade 1 steatosis, which may be a normal variant, were more readily detected in patients with breast cancer. This effect was aggravated by use of tamoxifen, but not the chemotherapy. Non-alcoholic fatty liver disease in patients with breast cancer may be associated with the primary tumor itself or some well-known risk factors such as obesity, hyperlipidemia, and diabetes mellitus, which needs to be explored.

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“…Elefsiniotis et al (2004) observed, in women with breast cancer and hepatic steatosis, that this drug induced hepatotoxicity in a large proportion of cases, especially when associated to high body mass index and high levels of glucose and serum lipids.…”

Section: Introductionmentioning

confidence: 99%

Liver iron overload induced by tamoxifen in diabetic and non-diabetic female Wistar rats

et al. 2007

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Tamoxifen (TX), a drug used in the treatment of breast cancer, may cause hepatic changes in some patients. The consequences of its use on the liver tissues of rats with or without diabetes mellitus (DM) have not been fully explored. The purpose of this study was to evaluate the correlation between plasma hepatic enzyme levels and the presence of iron overload in the hepatic tissue of female Wistar rats with or without streptozotocin-induced DM and using TX. Female rats were studied in control groups: C-0 (non-drug users), C-V (sorbitol vehicle only) and C-TX (using TX). DM (diabetic non-drug users) and DM-TX (diabetics using TX) were the test groups. Sixty days after induced DM, blood samples were collected for glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST) alkaline phosphatase (ALP) and bilirubin measures. Hepatic fragments were processed and stained with hematoxylin and eosin, Masson's trichrome, Perls. The hepatic iron content was quantified by atomic absorption spectrometry. AST, ALT and ALP levels were significantly elevated in the DM and DM-TX groups, with unchanged bilirubin levels. Liver iron overload using Perls stain and atomic absorption spectrometry were observed exclusively in groups C-TX and DM-TX. There was positive correlation between AST, ALT and ALP levels and microscopic hepatic siderosis intensity in group DM-TX. In conclusion, TX administration is associated with liver siderosis in diabetic and non-diabetic rats. In addition, TX induced liver iron overload with unaltered hepatic function in non-diabetic rats and may be a useful tool for investigating the biological control of iron metabolism.

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586 Tamoxifen (TMX)-induced hepatotoxicity in breast cancer (BC) patients with pre-existing liver steatosis (LS). The role of glucose intolerance

Cited by 6 publications

References 0 publications

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

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

A case–control study of non-alcoholic fatty liver disease in breast cancer

Liver iron overload induced by tamoxifen in diabetic and non-diabetic female Wistar rats

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