PMID: 8609812Dec 1, 1995Paper

Hepatotoxicity of intravenous cyclosporin A in patients with acute ulcerative colitis on total parenteral nutrition

Liver
G C ActisF Bonino

Abstract

A group of 24 patients underwent a 7-14-day course of continuously infused Cyclosporin A (2 mg.kg-1.day-1) to treat a severe attack of ulcerative colitis. In 19 of them, including eight treated with total parenteral nutrition, we retrospectively analyzed the serum aminotransferase (AST/ALT) levels at the beginning and at the end of Cyclosporin infusion. The baseline levels of AST/ALT in the group were 19.9 +/- 3.2 and 31.4 +/- 6.4; on stopping Cyclosporin infusion, they were 43 +/- 15.8 and 119 +/- 56, respectively. Six patients showed an ALT change above 1.5 times the upper limit of reference. They included five of the eight patients treated with total parenteral nutrition (62.5%). In one of six, ALT rose to 1000 U/l and was accompanied by full-blown febrile cholangitis (proven by liver biopsy). This episode was preceded by excessive accumulation of Cyclosporin in blood. The development of liver toxicity was independent of the length of Cyclosporin treatment, nor did it impair drug efficacy. Thus, in these patients total parenteral nutrition and Cyclosporin were synergistic, causing twice the frequency of liver damage (62.5%) reported for ulcerative colitis patients on total parenteral nutrition alone (37%). Total parenteral n...Continue Reading

Citations

Apr 4, 2002·Alimentary Pharmacology & Therapeutics·R N Cunliffe, B B Scott
Oct 20, 2010·Drug and Chemical Toxicology·Elife ErarslanTuncay Delibasi
Aug 5, 2011·Human & Experimental Toxicology·M TutancE Nacar
Apr 28, 2007·Journal of Applied Toxicology : JAT·Hasan KayaRamazan Durgut
Jun 24, 2008·Renal Failure·Mehmet DuruSadik Söğüt
Apr 7, 2010·Expert Opinion on Drug Metabolism & Toxicology·Shibashish GiriAugustinus Bader
Sep 30, 2014·Critical Reviews in Toxicology·Rachel P L van SwelmFrans G M Russel
Jul 29, 2006·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·William A Faubion, Athos Bousvaros
Nov 6, 2009·Gastroenterología y hepatología·Elena ToscanoRaúl J Andrade

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