Serum transaminase activities

Hepatic Effects. No studies were located regarding hepatic effects in humans after exposure to 3,3 -dichlorobenzidine. Information from animal studies on the liver effects of exposure to 3,3 -dichloro-benzidine suggests that exposme to sufficiently high levels of the compoimd could cause liver injury as indicated by modest elevation in serum transaminase activity, fatty liver (Stula et al. 1978), decrease in hepatic vitamin E, and lipid peroxidation (Iba 1987a Iba and Lang 1988 Iba and Thomas 1988). Some of these effects may contribute to the liver tumors induced. However, it is not known whether these liver injuries will occur in humans exposed to 3,3 -dichlorobenzidine at levels at which it occurs at hazardous... 

In a long-term inhalation study in rats, exposure to 1,4-dichlorobenzene at air concentrations of 490-499 ppm 5 hours per day, 5 days per week for 76 weeks resulted in an increase in absolute liver weight throughout the study in males and at weeks 27 and 112 in females (Riley et al. 1980). This effect was not accompanied by histological alterations or by increased serum transaminase activities. No hepatic effects were noted at 75 ppm. None of the adverse hepatic effects reported at lower concentrations of 1,4-dichlorobenzene for shorter durations (Hollingsworth et al. 1956), as described above, were identified in the 76-week study. Based on the NOAEL of 75 ppm for lack of hepatic effects, a chronic-duration MRL of 0.1 ppm was calculated as described in the footnote to Table 2-1 and in Appendix A (Hollingsworth et al. 1956). 

Curcumin (9) is an arylheptanoid isolated from turmeric, the rhizome of Curcuma longa L. Turmeric has been used as a remedy for inflammatory in Asia for centuries. There are a number of reports supporting an anti-inflammatory effect of curcumin. Its hepatoprotective activity against inflammatory liver injury was also demonstrated in a recent study [105], where pretreatment with curcumin (50 mg/kg, p.o.) significantly inhibited the elevation of serum transaminase activities after intoxication with D-GalN and LPS in mice. The hepatoprotective effect is presumably... 

Flutamide causes hepatotoxicity in some 0.36% of patients, and for this reason alone it should not be used in the absence of a serious indication. Whether bulimia nervosa in women justifies its use is open to doubt, since non-pharmacological methods of treatment are available. Furthermore, bulimia nervosa in women can be associated with raised serum testosterone concentrations. In a small double-blind study of the use of flutamide, citalo-pram, a combination of the two, or placebo in 31 women over 3 months, all the active treatments reduced the tendency to binge eating (47). However, there was a moderate and reversible increase in serum transaminase activities, leading to withdrawal in two of the 19 subjects who were taking flutamide either alone or in combination. 

There were increases in serum transaminase activities to more than three times the top end of the reference range in under 1% of patients taking cerivastatin, which is similar to findings with other statins (6). 

In several studies of co-administration of ezetimibe with a statin there have been small numbers of patients with raised serum transaminase activities at or above three times the upper limit of the reference range. 

Three men with phencyclidine intoxication developed severe malignant hyperthermia, respiratory failure, and coma (20). Two days later serum transaminase activity and bilirubin concentration rose markedly with prolongation of the prothrombin time. Liver biopsies showed marked peri-venular necrosis and collapse. One patient died. 

A 69-year-old man was given amiodarone intravenously 1500 mg for multiple coupled ventricular extra beats and 24 hours later developed acute hepatitis, with a 50-fold increase in serum transaminase activities and simultaneous increases in lactate dehydrogenase, gamma-glutamyl transferase, bilirubin, and prothrombin time there was a moderate leukocytosis and mild renal insufficiency (182). No further amiodarone was given and there was full recovery within 2 weeks. Other causes of acute hepatitis were excluded. 

A 26-year-old previously healthy man with hfe-threatening pulmonary blastomycosis developed increased hepatic transaminases to a maximum of ten times (aspartate transaminase) and 20 times (alanine transaminase), the upper limit of the reference ranges, 10 days after the addition of amphotericin (0.5 mg/kg) to his initial itraconazole therapy (200 mg bd) (95). The serum transaminase activities returned to normal within 4 days after withdrawal of amphotericin, and the blastomycosis was successfully treated with itraconazole alone. A liver biopsy showed mild focal fatty changes but no evidence of blastomycosis. 

A moderate increase in serum transaminase activities sometimes occurs in patients receiving GM-CSF. More severe hepatotoxicity has been briefly reported in patients who received GM-CSF after autologous bone marrow transplantation (SEDA-19, 342). Hyperbilirubinemia was also found in 8% of bone marrow transplant patients and considered as possible ground for molgramostim withdrawal (1). 

Moracizine can cause increased serum bUirubin concentrations and serum transaminase activities (7). 

Reversible hepatocellular injury has been reported with naltrexone in doses of up to 300 mg/day, which is five times that usually used for opioid blockade (SED-11, 147) (17). Five of twenty-six patients treated with naltrexone for obesity developed raised serum transaminase activities after 3-8 weeks of treatment. In another study in which 60 obese subjects received naltrexone for 8 weeks, there were abnormal liver function tests in six patients. Three patients failed to complete the course. Nausea and vomiting occurred within the first 24 hours of treatment but responded to a reduction in dose. There were also changes in mentation such as decreased mental acuity, depression, and anxiety, all of which resolved after withdrawal. This is significant, as adverse effects from naltrexone have previously been attributed to mild physical withdrawal syndromes. 

Niclofolan has been used to treat trematode infections, including clonorchiasis, fascioliasis, and paragonimiasis. Sweating, generalized pains, and transient rises in serum transaminase activities have been reported with niclofolan in the treatment of pulmonary infections due to Paragonimus uterobilaterali (SEDA-11, 597) (1). 

Experimental conditions in phase I trials have been described as being potentially responsible for changes in serum transaminase activities (7,8), perhaps ascribable to dietary factors and rest. 

Liver function abnormalities with Fansidar (pyrimethamine + sulfadoxine) vary from raised serum transaminase activities to more marked disturbances, with jaundice and granulomatous hepatitis. An occasional case of fatal hepatic failure has been reported this was the case in a young white American woman who had taken three doses of Fansidar with chloroquine (SEDA-12,242). Hepatic symptoms may be part of a vasculitis sjmdrome or can be seen in association with skin reactions (SEDA-13, 241). 

Rifampicin is rarely used as monotherapy. The risk of hepatotoxicity appears to be very low in patients with normal liver function, especially if rifampicin is given continuously. When given with isoniazid, rifampicin can cause a fulminant liver reaction. This may be attributable to enhancement of isoniazid hepatotoxicity as a result of enzyme induction by rifampicin. In some cases, jaundice occurred within 6-10 days after beginning isoniazid plus rifampicin (52). High serum transaminase activities, disturbances of consciousness, and centrilobular necrosis were found. All the patients recovered. 

Succimer is the meso isomer of 2,3-dimethylmercapto-succinic acid (DMSA). It is used as a lead chelator for oral administration (1). Nausea, vomiting, diarrhea, and anorexia are common. Rashes, sometimes necessitating withdrawal, have been reported in up to 10% of adults and 5% of children, and mild transient rises in serum transaminase activity in 6-10% (mostly adults) (2,3). Life-threatening hyperthermia occurred on two occasions in one subject, but no details were given. Iron can be safely and effectively given to patients taking succimer, which (unlike dimercaprol) does not appear to deplete iron stores or to form a toxic chelate that would preclude the parenteral administration of iron (3). 

Fortson W, Tedesco F, Starnes E, Shaw C. Marked elevation of serum transaminase activity associated with extrahepatic bhiary tract disease. J Clin Gastroenterol 1985 7 502-5. 

Effects on the liver are associated with exposure to hydrazines in humans (Sotaniemi et al. 1971) and animals (Haun and Kinkead 1973 Rinehart et al. 1960 Vemot et al. 1985 Wilson 1976). Therefore, assessment of serum transaminase activities may be useful in revealing liver damage in people exposed to hydrazines. Neurological effects are often observed following exposure to hydrazine and... 

Diarrhea abdominal pain migration of ascaris through mouth and nose leukopenia alopecia increased serum transaminase activity Benznidazole... 

When only small amounts of reactive metabolites are formed, severe toxic hepatitis does not occur. However, mild toxicity may still occur in metabolically susceptible patients, as shown by a clinically silent increase in serum transaminase activity. This mild toxicity causes the release of hepatic proteins, which have been modified by covalent binding with reactive metabolites (Pessayre and Larrey 2007). 

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