Hepatocellular injury in a patient receiving rosiglitazone - A case report

Background: Rosiglitazone maleate (Avandia, SmithKline Beecham, Philadelphi a, Pennsylvania) is a new oral hypoglycemic agent approved for the treatmen t of type 2 diabetes. It acts primarily by increasing insulin sensitivity. In controlled trials, there has been no evidence of rosiglitazone-induced h epatocellular injury. Objective: To report a case of hepatocellular injury in a patient receiving rosiglitazone, Design: Case report. Setting: Community teaching hospital. Patient: 61-year-old man receiving rosiglitazone, 4 mg/d for 2 weeks. Intervention: Discontinuation of rosiglitazone therapy. Measurements: Clinical evaluation and assessment of liver function test res ults were done daily during hospitalization and periodically after discharg e. The outpatient record was also reviewed. Results: After receiving rosiglitazone for 2 weeks, the patient presented w ith anorexia, vomiting, and abdominal pain. Liver function tests revealed s evere hepatocellular injury. Discontinuation of rosiglitazone therapy led t o rapid improvement of liver function and resolution of symptoms. Conclusion: Rosiglitazone may be associated with hepatocellular injury. We believe that patients receiving rosiglitazone should have liver enzyme leve ls monitored earlier and more frequently than initially recommended.