Cefdinir-Induced Hepatotoxicity: Potential Hazards of Inappropriate Antibiotic Use

Chen, Joy; Ahmad, Jawad

doi:10.1007/s11606-008-0758-y

Cited by 16 publications

(17 citation statements)

References 15 publications

(13 reference statements)

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“…A prominent increase in the levels of GGT suggest a toxic cause [3] . Development of he patitis and elevated liver enzymes caused by antibiotics have been reported in the literature [2][3][4][5][6][7][8][9] . Cephalosporin-induced hepatoxicity is rarely observed.…”

Section: Discussionmentioning

confidence: 99%

Ceftriaxone-induced toxic hepatitis

Peker¹,

Çağan²,

Doğan³

2009

WJG

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Toxic hepatitis or drug-induced liver injury encompasses a spectrum of clinical disease ranging from mild biochemical abnormalities to acute liver failure. The advantages of a long half-life, wide spectrum, high tissue penetration rate, and a good safety profile, make ceftriaxone, a third-generation cephalosporin, a frequent choice in the treatment of childhood infections. Previous studies have reported a few cases of high aspartate aminotransferase and alanine aminotransferase levels, along with three cases of hepatitis caused by ceftriaxone. Here, we report a case of drug-induced toxic hepatitis in a patient who was treated with ceftriaxone for acute tonsillitis.

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Section: Discussionmentioning

confidence: 99%

Ceftriaxone-induced toxic hepatitis

Peker¹,

Çağan²,

Doğan³

2009

WJG

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“…His eosinophil count had increased to 616/μL. It was first supposed that cefdinir, which has been reported to induce liver injury, caused liver injury to this patient because of the presence of eosinophilia and erythema. After discontinuing all drugs, the patient’s eosinophilia and erythema improved; however, the liver transaminase enzyme levels and IgG levels increased further.…”

Section: Case Reportmentioning

confidence: 85%

Immunoglobulin G4-associated autoimmune hepatitis later complicated by autoimmune pancreatitis: A case report

et al. 2015

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Immunoglobulin G4 (IgG4)-associated autoimmune hepatitis (AIH) is a new disease entity with elevated levels of serum IgG4 and marked IgG4 positive plasma cell infiltration of the liver, and its clinical course remains unknown. A patient with IgG4-associated AIH who later developed autoimmune pancreatitis (AIP) is reported. A 73-year-old man was admitted to our hospital due to elevated liver transaminase levels, hypergammaglobulinemia and positive antinuclear antibody. A liver biopsy specimen showed severe interface hepatitis with marked lymphoplasmacytic infiltration without damage to the interlobular bile ducts, and a diagnosis of AIH was made. Abdominal computed tomography showed no abnormalities in the pancreas. Prednisolone therapy normalized the transaminase levels. Two years later, the patient developed AIP, which recurred after 5 years due to a reduction in the prednisolone dose. Three years later, he had a recurrence of AIH after discontinuation of prednisolone treatment. Evaluation of serum IgG4 levels and IgG4-bearing plasma cell infiltration of the liver at both the onset and recurrence of AIH showed that the serum IgG4 levels were 284 and 208 mg/dL, respectively, and the IgG4-bearing plasma cell infiltration levels were 30-40 cells/high-power field (HPF) per portal area and 4-10 cells/HPF per portal area, respectively. From these results, this case was finally diagnosed as IgG4-associated AIH. The course of this patient demonstrates two important clinical lessons: (i) IgG4-associated AIH can later be complicated by AIP; and (ii) discontinuation of prednisolone treatment can cause recurrence of IgG4-associated AIH.

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“…There are many supporting literature where there are reports of mild hepatic injury causing insignificant rise in liver enzymes to toxic hepatitis [ Table 2 ]. [ 2 3 4 5 6 7 8 9 10 ] We also tried to find out the possible cause for the initial rise in the values at the time of admission. Since the history clearly mentions on usage of Cefixime suspension, we felt this might have created the initial increase.…”

Section: Discussionmentioning

confidence: 99%