Chronic liver failure induced by long-term administration of tegafur: A case report

A 55 year-old man was admitted with massive ascites. Although the laborator y data on admission were compatible with hepatic cirrhosis and remarkable e sophageal varices were observed during endoscopy, the imaging findings such as computed tomography and ultrasonographic examination did not confirm he patic cirrhosis. The patient had no history of alcohol abuse, blood transfu sions or acute hepatitis. Serological markers related to viral and autoimmu ne hepatitis were all negative. Seven years ago, the patient had undergone an operation for colon cancer and has been taking tegafur since then for a total of 55 months. Tegafur was suspected as the causative agent for the li ver dysfunction of this patient and the administration of tegafur was stopp ed. His laboratory data improved gradually and the ascites vanished. The fi rst Liver biopsy performed 6 months after discontinuation of tegafur still revealed chronic active hepatitis. However, at the liver biopsy performed 1 8 months after withdrawal of tegafur, inflammatory activity had subsided an d the third liver biopsy, performed 34 months thereafter, revealed further improvement of the pathological changes that had occurred in the Liver. We therefore conclude that the administration of tegafur may have caused chron ic active liver injury with portal hypertension manifested as ascites and e sophageal varices.