FATAL ACUTE FULMINANT LIVER-FAILURE DUE TO CLOZAPINE - A CASE-REPORT AND REVIEW OF CLOZAPINE-INDUCED HEPATOTOXICITY

Clozapine-induced hepatotoxicity is not well known and is usually of n o clinical significance. This report describes fatal acute fulminant l iver failure caused by clozapine in a 39-year-old man with chronic par anoid schizophrenia. The hepatotoxicity of clozapine is reviewed. Asym ptomatic elevation of transaminase levels is observed most commonly, a ffecting between 30% and 50% of patients. Icteric hepatitis is uncommo n, noted in 84 of 136,000 patients (0.06%). Fatal acute fulminant hepa titis has been documented in 2 patients (0.001%). The mechanism of clo zapine hepatotoxicity is unknown. Although serious toxicity is rare, p rescribers of clozapine should be aware of the hepatotoxic potential.