Acute hepatitis induced by cyproterone acetate

• Published in: The Annals of pharmacotherapy 2001-09, Vol.35 (9), p.1053-1055
• Main Authors: Giordano, N, Nardi, P, Santacroce, C, Geraci, S, Gennari, C
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Aged; Antineoplastic Agents - adverse effects; Biological and medical sciences; Chemical and Drug Induced Liver Injury - etiology; Chemical and Drug Induced Liver Injury - pathology; Cyproterone Acetate - adverse effects; Drug toxicity and drugs side effects treatment; Humans; Male; Medical sciences; Pharmacology. Drug treatments; Prostatic Neoplasms - drug therapy; Toxicity: digestive system
• ISSN: 1060-0280; 1542-6270
• DOI: 10.1177/106002800103500902

OBJECTIVE: To report a case of acute hepatitis resulting from the use of cyproterone acetate, an adjuvant treatment for prostate cancer. CASE SUMMARY: An 87-year-old white man, admitted to surgery for prostate cancer, received cyproterone acetate 300 mg/d orally and developed acute hepatitis, which initially was diagnosed clinically. A liver biopsy showed changes suggestive of acute cholestatic hepatitis. Cyproterone was stopped immediately, and the patient was subsequently treated with corticosteroids. He then improved rapidly. DISCUSSION: Cyproterone acetate is thought to be well tolerated, but some authors have reported severe hepatic reactions, in particular acute hepatitis, fatal fulminant hepatic failure, and hepatocellular carcinoma. The above-mentioned hepatotoxicity represents an idiosyncratic drug reaction, probably due to the hepatomitogen action of cyproterone, causing an increase of hepatocytes expressing placental glutathione S-transferase, which are considered preneoplastic elements. CONCLUSIONS: This case suggests the possibility of hepatotoxicity from cyproterone.