Severe drug-induced liver injury caused by levetiracetam – A case report and review of the literature

•DILI is an adverse reaction with incidence in general between 1 in 1000 and 1 in 100,000.•We report DILI two months after initiation of LEV therapy without possible triggering factors.•Problably idiosyncratic DILI with onset several days to months after initiation of LEV therapy.•Higher incidence o...

Full description

Saved in:
Bibliographic Details
Published in:Epilepsy & behavior reports 2021-01, Vol.16, p.100464, Article 100464
Main Authors: Rogalewski, Andreas, Zuhorn, Frédéric, Wilkens, Ludwig, Krüger, Martin, Klingebiel, Randolf, Schäbitz, Wolf-Rüdiger
Format: Article
Language:English
Subjects:
Anticonvulsants
Case Report
Drug induced liver injury
Hepatotoxicity
Levetiracetam
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:•DILI is an adverse reaction with incidence in general between 1 in 1000 and 1 in 100,000.•We report DILI two months after initiation of LEV therapy without possible triggering factors.•Problably idiosyncratic DILI with onset several days to months after initiation of LEV therapy.•Higher incidence of DILI due to LEV in women (female:male 1.5:1).•Discontinuation of LEV as first therapeutic measure; immunosuppression with cortisone for serious cases. Levetiracetam (LEV) is a broad-spectrum, second-generation anti-seizure medication, which has quickly become one of the most commonly prescribed drugs for people with epielpsy due to its good tolerability, rapid up-dosing capability, with both parenteral and enteral routes of administration. Considering the frequent prescriptions and predominant excretion by the kidney with minimal hepatic metabolism, severe liver injury is very rarely a complication associated with LEV. An analysis of this reported case and further published cases was performed with respect to indication, relevant previous liver diseases, concomitant medication, and both the dosage as well as the duration of LEV when drug-induced liver injury (DILI) was noted. DILI occurs after a few days to a maximum of five months after initiation of therapy with LEV and, in the worst case, may require liver transplantation or result in death. Monitoring of serum transaminase values may be helpful. Discontinuing LEV is the first therapeutic measure. In addition, immunosuppression with cortisone can be considered for serious cases.
ISSN:2589-9864
2589-9864
DOI:10.1016/j.ebr.2021.100464