Fipexide-induced fulminant hepatitis. Report of three cases with emergency liver transplantation.

Abstract

Fipexide belongs to a new class of cognition activators and is noted for its lack of amphetamin-like side effects. We describe three patients who developed fulminant hepatic failure less than 2 months after beginning fipexide administration. The mean interval from the onset of jaundice to the onset of encephalopathy was 8 days. Emergency liver transplantation was undertaken when factor V was 20% of normal or less and coma developed. All patients were transplanted less than 1 week after the onset of encephalopathy. Two survived and one died immediately after transplantation. Histologic examination of the livers revealed massive liver cell necrosis, predominantly centrilobular, and a moderate inflammatory infiltrate within the portal spaces. We conclude that fipexide can induce massive liver cell necrosis and fulminant liver failure. As a result of this life-threatening complication, reconsideration of the indications for this drug is warranted.

• Authors: F Durand, D Samuel, J Bernuau, F Saliba, E A Pariente, S Marion, J P Benhamou, H Bismuth
• Journal: Journal of hepatology (J Hepatol) Vol. 15 Issue 1-2 Pg. 144-6 (May 1992) ISSN: 0168-8278 [Print] Netherlands
• PMID: 1506632 (Publication Type: Case Reports, Journal Article)

Chemical References

• Piperazines
• fipexide

Topics

• Adolescent
• Adult
• Chemical and Drug Induced Liver Injury
• Female
• Hepatic Encephalopathy (chemically induced, surgery)
• Humans
• Liver (drug effects, pathology, surgery)
• Liver Transplantation
• Male
• Piperazines (adverse effects)
• Severity of Illness Index