Alfuzosin-induced acute hepatitis in a patient with chronic liver disease

Ann Pharmacother. 2004 Sep;38(9):1443-5. doi: 10.1345/aph.1D633. Epub 2004 Jul 27.

Abstract

Objective: To report a new case of probable alfuzosin-induced hepatitis.

Case summary: An 80-year-old man was evaluated because of jaundice and pruritus. He was diagnosed as having Child-Pugh A chronic liver disease due to hepatitis B virus. Other etiologies of hepatitis were appropriately ruled out, and the hepatitis B was non-replicative. Therefore, elevated liver enzyme levels were ascribed to alfuzosin treatment.

Discussion: Although alfuzosin-related mixed-type hepatotoxicity has been previously reported, this is the first published case describing probable hepatocellular-type hepatotoxicity resulting from use of alfuzosin in a patient with underlying chronic liver disease. According to the Naranjo probability scale, alfuzosin was a probable cause of the hepatotoxicity. The mechanism of alfuzosin-induced liver damage is unknown. Several features, such as absence of predictable dose-dependent toxicity of alfuzosin in previous studies and absence of hypersensitivity manifestations in our case, are suggestive of a metabolic type of idiosyncratic toxicity.

Conclusions: Alfuzosin rarely causes hepatotoxicity; however, clinicians must be alert for this adverse effect while using alfuzosin.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adrenergic alpha-Antagonists / adverse effects*
  • Aged, 80 and over
  • Chemical and Drug Induced Liver Injury / etiology*
  • Hepatitis B, Chronic / complications*
  • Humans
  • Liver / enzymology
  • Liver / metabolism
  • Liver Function Tests
  • Male
  • Quinazolines / adverse effects*

Substances

  • Adrenergic alpha-Antagonists
  • Quinazolines
  • alfuzosin