Severe liver injury after initiating therapy with atomoxetine in two children

Joel R Lim; Philip R Faught; Naga P Chalasani; Jean P Molleston

doi:10.1016/j.jpeds.2006.01.035

Severe liver injury after initiating therapy with atomoxetine in two children

J Pediatr. 2006 Jun;148(6):831-4. doi: 10.1016/j.jpeds.2006.01.035.

Authors

Joel R Lim¹, Philip R Faught, Naga P Chalasani, Jean P Molleston

Affiliation

¹ Division of Pediatric Gastroenterology/Hepatology/Nutrition, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202-5225, USA. jdlim@iupui.edu

PMID: 16769398
DOI: 10.1016/j.jpeds.2006.01.035

Abstract

Two children presented with acute hepatitis after starting therapy with atomoxetine (Strattera). In one child, no competing diagnosis could be identified, and liver injury resolved completely on withdrawal of the medication. In the second child, the evaluation was suggestive of type 1 autoimmune hepatitis; she subsequently improved with removal of atomoxetine and concomitant immunosuppressive therapy. Atomoxetine may cause clinically significant hepatotoxicity either by metabolic idiosyncrasy or by inducing autoimmune hepatitis.

Publication types

Case Reports

MeSH terms

Adrenergic Uptake Inhibitors / adverse effects*
Adrenergic Uptake Inhibitors / immunology
Adrenergic Uptake Inhibitors / pharmacology
Adrenergic Uptake Inhibitors / therapeutic use
Atomoxetine Hydrochloride
Chemical and Drug Induced Liver Injury / etiology*
Chemical and Drug Induced Liver Injury / therapy
Child
Cytochrome P-450 CYP2D6 / metabolism
Female
Hepatitis, Autoimmune / etiology*
Humans
Propylamines / adverse effects*
Propylamines / immunology
Propylamines / pharmacology
Propylamines / therapeutic use

Substances

Adrenergic Uptake Inhibitors
Propylamines
Atomoxetine Hydrochloride
Cytochrome P-450 CYP2D6