Avtor/Urednik		Gabršček, Lucija; Štepec, Srečko; Markovič, Saša
Naslov		Akutni medikamentozni hepatitis - prikaz primera
Prevedeni naslov		Acute medicamentous hepatitis - case report
Tip		članek
Vir		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 6. Zbornik 7. mednarodni simpozij o urgentni medicini; 2000 jun 14-17; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2000
Obseg		str. 457-61
Jezik		slo
Abstrakt		Flutamide is nonsteroid antiandrogen used for prostatic carcinoma treatment. Its hepatotoxicity is known and can cause mild hepatic injury or fulminant hepatic failure. 63 years old men was admitted to hospital because of jaundice, abdominal pain, malaise and nausea. He noticed a dark urine. For the last 10 weeks he was treatecl with flutamide for prostate cancer. The liver function was abnormal with elevatecl liver enzymes (predominantly aminotransferases), hyperbilirubinemia and prolonged protrombin time. We excluded extrahepatic obstruction with ultrasound ancl ERCP. Markers for viral hepatitis ruled out acute disease. He had no previous liver disease and he was taking any medication. We thought on drug toxicity and immediately after admission flutamide was discontinued. Plasma bilirubin was increasing until day 16 and then it started to decrease. Two weeks after admission protrombin time was normal. After 4 weeks the patient was dismissed. One month later liver enzymes and bilirubin were still mildly elevated (2 folds normal values), but protrombin was normal. The incidence of flutamide toxicity is 1-5%. When flutamide is prescribed, liver function should be monitored regularly. In the case of progressive liver failure the drug must be discontinued and when it doesn't help, liver transplantation is the only effective treatment.
Deskriptorji		HEPATITIS, TOXIC MIDDLE AGE FLUTAMIDE LIVER TRANSPLANTATION LIVER FAILURE MONITORING, PHYSIOLOGIC BIOLOGICAL MARKERS HYPERBILIRUBINEMIA