Suspected drug-induced liver injury associated with iguratimod: a case report and review of the literature

Iguratimod is a novel anti-rheumatic drug with the capability of anti-cytokines as report goes. It has been reported that iguratimod is effective and safe for rheumatoid arthritis and other rheumatisms. As side effects, iguratimod can cause gastrointestinal reactions, dizziness, headache and itchy....

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Bibliographic Details
Published in:BMC gastroenterology 2018-08, Vol.18 (1), p.130-6, Article 130
Main Authors: Li, Xiao-Li, Liu, Xiao-Chang, Song, Yu-Lin, Hong, Ru-Tao, Shi, Hai
Format: Article
Language:English
Subjects:
Abdomen
Anti-inflammatory agents
Case Report
Case reports
Clinical features
Complications and side effects
Cytokines
Dosage and administration
Drug therapy
Drug-induced liver injury
Drugs
Enzymes
Gastroenterology
Headache
Hepatitis
Hepatology
Hepatotoxicity
Iguratimod
International organizations
Literature reviews
Liver
Liver diseases
Methylprednisolone
Pathogenesis
Patients
Pneumonia
Rheumatoid arthritis
Risk factors
Sjogren's syndrome
Surveillance
Treatment
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Summary:Iguratimod is a novel anti-rheumatic drug with the capability of anti-cytokines as report goes. It has been reported that iguratimod is effective and safe for rheumatoid arthritis and other rheumatisms. As side effects, iguratimod can cause gastrointestinal reactions, dizziness, headache and itchy. In this case report, a 60-year-old female patient was admitted with suspected drug-induced liver injury (DILI) caused by iguratimod. The causality assessment was done by the updated RUCAM, and the possibility of the case in our paper diagnosed as highly probable for the score was 9 points. Iguratimod was discontinued immediately, and methylprednisolone was used for acute liver injury and Sjogren's syndrome. The data showed the patient has improved gradually, and she was discharged on day 27. The true incidence of iguratimod-related hepatotoxicity and its pathogenic mechanism are largely unknown. It is difficult to recognize and diagnose DILI, and there is no standard for diagnosis of DILI. At the same time, the DILI is still lack of specific treatment. Based on this rare case of severe liver injury, we recommend careful monitoring of liver function throughout iguratimod treatment for diseases.
ISSN:1471-230X
1471-230X
DOI:10.1186/s12876-018-0858-z