Development of hepatocellular carcinoma after long-term immunosuppressive therapy including danazol in a dog

Abstract

A 2-year-old female beagle was referred to our hospital for evaluation of anemia. Laboratory tests, including bone marrow cytology, revealed non-regenerative immune-mediated anemia (NRIMA). Although initial immunosuppressive multi-drug therapy was not effective, additional administration of danazol was successful in treating the anemia. However, hepatocellular carcinoma (HCC) developed about 20 months after the administration of danazol. In humans, several cases of development of HCC after the administration of danazol have been reported. The present report describes a case of HCC development in a dog after chronic administration of danazol in addition to other immunosuppressive drugs.

>b<Mutational evaluation of TP53 gene in the canine hepatocellular carcinoma>/b<: a comparative approach

“…Adverse long-term effect leading to HCC was identified by prolonged Danazol therapy in a 2-years female beagle to treat non-regenerative immune-mediated anemia. In this case, two hepatic masses appeared in different moments during immunosuppressive treatment (KOBAYASHI et al, 2016). This adverse effect also has been observed in human in few cases where danazol is used to treatment of endometriosis, lupus erythematosus, idiopathic thrombocytopenic purpura and other autoimmune conditions.…”

Danazol: An Effective and Underutilised Treatment Option in Diamond-Blackfan Anaemia

“…It also has mild immunosuppressive properties via inhibition of TNF-alpha and IL-1 [20]. Its side effect profile is unsurprisingly related to hyperandrogenism but is also rarely associated with the development of hepatocellular carcinoma (HCC) and hepatocellular adenomas [21, 22].…”