Acute severe liver dysfunction induced by febuxostat in a patient undergoing hemodialysis

Abstract

A 58-year-old man with chronic kidney disease (CKD) was admitted to our hospital for hemodialysis (HD) therapy. He had been administered allopurinol (100 mg/ day) before hospitalization, and we replaced it with febuxostat (10 mg/day), a new xanthine oxidase inhibitor. Levels of aspartate aminotransferase, alanine transaminase (ALT), and lactate dehydrogenase were within the normal ranges in the morning before febuxostat administration, but 6 h after administration, these parameters increased markedly to approximately 10 times the levels before administration. Although we stopped administering febuxostat, his serum potassium levels increased at a rate of 1 mmol/L every 12 h, and he had to undergo HD daily to lower the serum potassium levels. The levels of liver function test parameters peaked on the fourth hospital day (ALT, 1134 IU/L; AST, 1485 IU/L; and LDH, 1869 IU/L) and recovered to normal ranges on the 13th hospital day. In this case, febuxostat appeared to have a relationship with acute liver dysfunction in the clinical course. Therefore, it would be important to check liver function test parameters frequently after febuxostat initiation and also to initiate a lower than usual dose of febuxostat, especially in patients with CKD and those who are undergoing HD.

Ascites management by cell-free concentrated ascites reinfusion therapy during recovery from drug-induced acute liver injury: a case report

“…The biliary system obstruction mechanism is not recognized. The liver volume measured by CT is 1973 cm 3 . b (Day 37): the liver atrophied with massive ascites.…”

“…b (Day 37): the liver atrophied with massive ascites. The liver volume is 1419 cm 3 . c (Day 284): the liver is regenerating and growing.…”

“…Ascites are reduced. The liver volume is 1587 cm 3 . The number of days from the date of hospitalization to the date of examination Fig.…”

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A Novel Multi-Epitope Vaccine Based on Urate Transporter 1 Alleviates Streptozotocin-Induced Diabetes by Producing Anti-URAT1 Antibody and an Immunomodulatory Effect in C57BL/6J Mice

“…It has been reported that benzbromarone could lower the level of blood glucose in db / db mice and inhibit human fatty acid binding protein 4 [ 41 , 46 ]. However, all of them are chemical drugs that can lead to allergies and many side effects [ 47 , 48 ]. They have been demonstrated to produce adverse effects such as hypersensitivity and agranulocytosis [ 49 ].…”