Thalidomide-associated hepatitis: a case report.

Abstract

We report a case of hepatitis in a 58-year-old woman being treated with thalidomide for end-stage plasma cell leukemia. The patient had a medical history including chronic stable hepatitis C infection. At diagnosis there was a severe anemia, thrombocytopenia, hypercalcemia, IgG paraproteinemia, peripheral blood myeloma cells, and a marrow plasmacytosis with lytic bony lesion. The disease was refractory to standard chemotherapy, and she was treated with oral thalidomide. Within 1 week she became jaundiced and developed a marked transaminitis. This promptly resolved upon cessation of thalidomide alone. Thalidomide has recently enjoyed renewed interest as a treatment in many disorders, including plasma cell leukemia. To our knowledge, this is the first reported case of thalidomide-associated hepatotoxicity. Although the mechanism of its actions on the liver are uncertain, it is possible that thalidomide acts as a direct hepatotoxin or as an immuno-modulator, altering the activity of chronic viral hepatitis. We present this case to increase awareness of a new potential side effect of thalidomide as its clinical indications expand.

• Authors: R Fowler, K Imrie
• Journal: American journal of hematology (Am J Hematol) Vol. 66 Issue 4 Pg. 300-2 (Apr 2001) ISSN: 0361-8609 [Print] United States
• PMID: 11279644 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2001 Wiley-Liss, Inc.

Chemical References

• Antineoplastic Agents
• Estrogens, Conjugated (USP)
• Thalidomide
• Vincristine
• Dexamethasone
• Doxorubicin
• Medroxyprogesterone Acetate
• Megestrol Acetate

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Chemical and Drug Induced Liver Injury (blood, etiology)
• Dexamethasone (administration & dosage)
• Doxorubicin (administration & dosage)
• Estrogens, Conjugated (USP) (administration & dosage)
• Fatal Outcome
• Female
• Hepatitis C (complications)
• Humans
• Leukemia, Plasma Cell (drug therapy)
• Medroxyprogesterone Acetate (administration & dosage)
• Megestrol Acetate (administration & dosage)
• Middle Aged
• Salvage Therapy
• Thalidomide (administration & dosage, adverse effects)
• Thrombocytopenia (chemically induced)
• Vincristine (administration & dosage)