Drug-induced hepatitis in an acromegalic patient during combined treatment with pegvisomant and octreotide long-acting repeatable attributed to the use of pegvisomant

Eur J Endocrinol. 2006 Jun;154(6):805-6. doi: 10.1530/eje.1.02160.


We report on a patient with acromegaly who developed severe drug-induced hepatitis during combined treatment with the long-acting somatostatin-analog octreotide and the GH receptor antagonist pegvisomant. The hepatic enzyme disturbances normalized after discontinuation of pegvisomant. After rechallenge with monotherapy pegvisomant, however, the hepatic enzyme disturbances reappeared within a few weeks, indicating that most likely pegvisomant alone and not the long-acting somatostatin analog or the combination of these two drugs was responsible for this case of drug-induced hepatitis. Clinicians should be aware of this potential severe adverse drug reaction and therefore frequent control of hepatic enzymes is mandatory during treatment with pegvisomant.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly / complications
  • Acromegaly / drug therapy*
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Chemical and Drug Induced Liver Injury / etiology*
  • Human Growth Hormone / adverse effects
  • Human Growth Hormone / analogs & derivatives*
  • Humans
  • Liver / enzymology
  • Male
  • Middle Aged
  • Octreotide / therapeutic use*
  • gamma-Glutamyltransferase / blood


  • Human Growth Hormone
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • pegvisomant
  • Octreotide