oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Hepatotoxicity by bosentan in a patient with portopulmonary hypertension: a case-report and review of the literature
Dept Med, Div Gastroenterol, Örebro Univ Hosp, Örebro, Sweden.ORCID iD: 0000-0002-1046-383x
Örebro University, School of Health and Medical Sciences.
Dept Cardiol, Örebro Univ Hosp, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences.
2011 (English)In: Journal of Gastrointestinal and Liver Diseases, ISSN 1841-8724, E-ISSN 1842-1121, Vol. 20, no 1, p. 77-80Article in journal (Refereed) Published
Abstract [en]

Bosentan is an endothelin receptor antagonist approved for treatment of pulmonary arterial hypertension. Mild liver reactions occur in about 10% of treated patients but severe hepatotoxicity is rare. We present clinical data and treatment outcome of a severe drug induced liver injury due to bosentan in a patient with non-cirrhotic portopulmonary hypertension. After 18 months of uncomplicated therapy with bosentan 125 mg b.i.d., the patient developed a severe mixed hepatic injury. Serum levels of bilirubin were 316 µmol/l (ref. value <20 micromol/l), AST 14 µkat/l (ref. value < 0.9 µkat/l), ALT 10 µkat/l (ref. value < 0.9 µkat/l), ALP 8 µkat/l (ref. value <1.8 µkat/l) and INR 1.8 (ref. value 0.9-1.1). Complete diagnostic work-up disclosed no other cause of hepatotoxicity. Treatment with prednisolone 40 mg/day in tapering doses was ultimately added and the patient made a full recovery. Subsequent treatment with sildenafil and ambrisentan for pulmonary arterial hypertension was well tolerated and liver function tests have remained normal during 12 months' follow-up. A review of the literature revealed three other women with severe hepatotoxicity due to bosentan. Bosentan may cause severe liver injury, even after long uneventful therapy, and current recommendations on regular monitoring of liver function tests are reinforced. Ambrisentan may be a therapeutic alternative in patients with pulmonary arterial hypertension and hepatotoxicity by bosentan.

Place, publisher, year, edition, pages
Cluj: Medical University Press , 2011. Vol. 20, no 1, p. 77-80
National Category
Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-24212ISI: 000289044100014PubMedID: 21451802OAI: oai:DiVA.org:oru-24212DiVA, id: diva2:542806
Available from: 2012-08-03 Created: 2012-08-03 Last updated: 2019-03-04Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

PubMedhttp://www.jgld.ro/2011/1/14.pdf

Authority records BETA

Eriksson, CarlGustavsson, AndersTysk, Curt

Search in DiVA

By author/editor
Eriksson, CarlGustavsson, AndersTysk, Curt
By organisation
School of Health and Medical Sciences
In the same journal
Journal of Gastrointestinal and Liver Diseases
Gastroenterology and Hepatology

Search outside of DiVA

GoogleGoogle Scholar

pubmed
urn-nbn

Altmetric score

pubmed
urn-nbn
Total: 355 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf