Subacute hepatic failure associated with a new antidiabetic agent, troglitazone: a case report with autopsy examination

Hum Pathol. 2000 Feb;31(2):250-3. doi: 10.1016/s0046-8177(00)80229-4.


An autopsy case of fatal subacute hepatic failure after administration of troglitazone is described. The liver dysfunction developed about five months after the patient, a sixty-three-year-old woman, had been initially treated with troglitazone. The patient developed hepatic failure and died despite various hepatic auxiliary treatments such as plasmapheresis. Autopsy findings revealed focal liver cell necrosis, cholestasis and steatosis with infiltration of lymphocytes and neutrophils and lack of regenerative activity. The causative mechanism of liver dysfunction may be metabolite aberration, as a result of accumulation of hepatotoxic metabolite(s), in a category of idiosyncratic liver injury. It is proposed to monitor liver function strictly and periodically for the diabetic patients prescribed troglitazone.

Publication types

  • Case Reports

MeSH terms

  • Chromans / adverse effects*
  • Chromans / therapeutic use
  • Diabetes Mellitus, Type 2 / drug therapy
  • Fatal Outcome
  • Female
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / therapeutic use
  • Liver Failure / chemically induced*
  • Liver Failure / pathology
  • Middle Aged
  • Necrosis
  • Thiazoles / adverse effects*
  • Thiazoles / therapeutic use
  • Thiazolidinediones*
  • Troglitazone


  • Chromans
  • Hypoglycemic Agents
  • Thiazoles
  • Thiazolidinediones
  • Troglitazone