Abnormal liver function tests

Cyclosporine is a cyclic polypeptide immunosuppressant typically used to prevent organ rejection in transplant patients. Its use is restricted to patients with fulminant or refractory symptoms in patients with active IBD. Significant toxicides associated with cyclosporine are nephrotoxicity, risk of infection, seizures, hypertension, and liver function test abnormalities.1,13,14... 

Flutamide 750 mg/day Gynecomastia Hot flushes Gastrointestinal disturbances (diarrhea) Liver function test abnormalities Breast tenderness Methemoglobinemia... 

Carboplatin -atypical alkylating agent leading to DNA strand breakage during replication -bone marrow suppression—particularly thrombocytopenia -nausea and vomiting -liver function test abnormalities -uncommon neurotoxicity, ototoxicity... 

Amiodarone Tremor, ataxia, pareslfresia, insomnia, corneal microdeposits, optic neuropathy/neuritis, nausea, vomiting, anorexia, constipation, TdP (<1%), bradycardia or AV block (IV and oral use), pulmonary fibrosis, liver function test abnormalities, hepatitis, hypothyroidism, hyperthyroidism, photosensitivity, bluegray skin discoloration, hypotension (IV use), phlebitis (IV use)... 

The adverse effects of antiandrogens are gynecomastia, hot flushes, GI disturbances, liver function test abnormalities, and breast tenderness. GI disturbances consist of diarrhea for flutamide and bicalutamide and nausea or constipation for nilutamide. Flutamide is also associated with methemoglobinemia, whereas nilutamide causes visual disturbances (impaired dark adaptation), alcohol intolerance, and interstitial pneumonitis. 

Liver function test abnormalities are common. If aminotransferases are greater than three times the upper limit of normal, the antipsychotic should be changed to a chemically unrelated antipsychotic. These changes are less common with the SGAs but are reported with risperidone and clozapine. 

Cholestatic hepatitis has been reported with risperidone, and liver function test abnormalities (mostly transient) have been reported with olanzapine and clozapine. 

Parenfera/- The most important treatment-emergent adverse effects were hypotension, asystole/cardiac arrest/electromechanical dissociation (EMD), cardiogenic shock, CFIF, bradycardia, liver function test abnormalities, VT, and AV block. The most common adverse effects leading to discontinuation of IV therapy were hypotension, asystole/cardiac arrest/EMD, VT, and cardiogenic shock. Adverse reactions occurring in at least 3% of patients include nausea. 

If symptoms of hepatitis accompanied by liver function test abnormalities or jaundice appear, discontinue therapy. If caused by dantrolene and detected early, abnormalities may revert to normal when the drug is discontinued. See Warning Box. 

Nausea vomiting diarrhea (clindamycin 3.4% to 30%) pseudomembranous colitis (clindamycin 0.01% to 10% 3 to 4 times more frequent with oral administration) neutropenia (sometimes transient) leukopenia agranulocytosis thrombocytopenic purpura skin rashes, urticaria, erythema multiforme anaphylaxis jaundice liver function test abnormalities (serum transaminase elevations). 

Adverse reactions occurring in at least 3% of patients included the following abnormal vision, alkaline phosphatase increased, ALT/AST increased, chills, fever, hallucinations, headache, hepatic enzymes increased, liver function test abnormal, nausea, peripheral edema, photophobia, rash, vomiting. 

Lab test abnormalities Liver function test abnormalities, CPK or creatinine elevations, lymphopenia, triglyceride elevations occurred in at least 3% of patients. 

Transient liver function test abnormalities are observed frequently after methotrexate administration and are usually not cause for modification of therapy. Persistent liver function test abnormalities and/or depression of serum albumin may be indicators of serious liver toxicity and require evaluation. 

Nausea and mucosal ulcers are the most common toxicities. Progressive dose-related hepatotoxicity in the form of enzyme elevation occurs frequently, but cirrhosis is rare (< 1%). Liver toxicity is not related to serum methotrexate concentrations, and liver biopsy follow-up is only recommended every 5 years. A rare hypersensitivity-like lung reaction with acute shortness of breath is documented, as are pseudolymphomatous reactions. The incidence of gastrointestinal and liver function test abnormalities can be reduced by the use of leucovorin 24 hours after each weekly dose or by the use of daily folic acid, although this may decrease the efficacy of the methotrexate. This drug is contraindicated in pregnancy. 

Gershovich OE, Lyman AE Jr. Liver function test abnormalities and pruritus in a patient treated with atorvastatin case report and review of the literature. Pharmacotherapy 2004 24 15CM. 

The frequency of liver function test abnormalities in patients taking monobactams does not differ from the frequencies in patients taking other beta-lactam antibiotics (3,6,9). 

The finding of mild to moderate liver function test abnormalities that normalized on dosage reduction or withdrawal of tacrohmus has suggested possible dose-related hepatotoxicity (66). In fiver transplant patients, fiver biopsy showed a centrilobular hepatocellular dropout with sinusoidal dilatation and congestion, and no features of cellular rejection or acute hepatitis. 

Liver function test abnormalities in patients taking voriconazole are not unexpected for an azole and can be explained by its extensive hepatic metabolic clearance (12). 

CNS side effects occur in 5 to 15% of patients and range in severity from headache to behavioral changes to convulsions and coma. About one-third of patients have had to interrupt or prematurely stop intravenous ganciclovir therapy because of bone marrow or CNS toxicity. Infusion-related phlebitis, azotemia, anemia, rash, fever, liver function test abnormalities, nausea or vomiting, and eosinophilia also have been described. 

Investigations in a phase I trial determined the MTD with 2.5 mg/m and neutropenia, peripheral oedema as well as liver function test abnormalities as dose-limiting toxicities [89]. Phase II trails in patients with malignant melanoma noted only a small percentage of responders, but significant duration of response in patients with liver metastases [90]. Only a few data are published on ILX-651 developed by Ilex Oncology. Data from a phase I study have been reported showing reasonable tolerability but short plasma half-life [91]. ILX 651 is currently in multicentric phase II studies in advanced melanoma or NSCLC patients with additional trials scheduled. 

Chanwai, L.G. 2000. Kava toxicity. Emerg. Med. 12(2) 142-145. Clough, A.R., R.S. Bailie, and B. Currie. 2003. Liver function test abnormalities in users of aqueous kava extracts.. Toxicol. Clin. Toxicol. 41(6) 821-829. 

Standard liver function test abnormalities were found in three gout patients who had elevation of serum aspartate amino transferase (Table 3). These also had abnormal B.S.P. retention (more than 5/ at 45 minutes after injection) and a total of I4 of the gout subjects had retention exceeding the normal. 

McGoon MD, Frost AE, Oudiz RJ, Badesch DB, Galie N, Olschewski H, McLaughlin W, Gerber MJ, Dufton C, Despain DJ, Rubin LJ. Ambrisentan therapy in patients with pulmonary arterial hypertension who discontinued bosentan or sitaxsentan due to liver function test abnormalities. Chest 2009 135(1) 122-9. 

The most common liver function test abnormality in hepatic sarcoidosis is an elevated serum alkaline phosphatase, which is present in more than 90% of patients with signs or symptoms of hepatic sarcoidosis (59,67,68) but is found in as few as 15% (32/217) of patients with histologic evidence of disease (62). Occasionally, this elevation may exceed 5 to 10 times the upper limits of normal... 

Granulomatous hepatitis from sarcoidosis may require treatment if patients develop fever, nausea, vomiting, pruritus weight loss, or right upper-quadrant abdominal pain (67). Corticosteroids are usually effective in alleviating these symptoms (67,93). Many patients require a daily dose of prednisone in the 10 to 15 mg range. Therapy is often required for more than one year (67). Despite the potential risk of hepatic toxicity from methotrexate, it has been shown to be effective, reduce liver function test abnormalities, and to be corticosteroid sparing (67,95). 

Liver-function test abnormalities have been noted among patients treated with guanoxan. ... 

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