Suspected drug-induced liver injury associated with iguratimod: a case report and review of the literature

BMC Gastroenterology
Xiao-Li LiHai Shi

Abstract

Iguratimod is a novel anti-rheumatic drug with the capability of anti-cytokines as report goes. It has been reported that iguratimod is effective and safe for rheumatoid arthritis and other rheumatisms. As side effects, iguratimod can cause gastrointestinal reactions, dizziness, headache and itchy. In this case report, a 60-year-old female patient was admitted with suspected drug-induced liver injury (DILI) caused by iguratimod. The causality assessment was done by the updated RUCAM, and the possibility of the case in our paper diagnosed as highly probable for the score was 9 points. Iguratimod was discontinued immediately, and methylprednisolone was used for acute liver injury and Sjogren's syndrome. The data showed the patient has improved gradually, and she was discharged on day 27. The true incidence of iguratimod-related hepatotoxicity and its pathogenic mechanism are largely unknown. It is difficult to recognize and diagnose DILI, and there is no standard for diagnosis of DILI. At the same time, the DILI is still lack of specific treatment. Based on this rare case of severe liver injury, we recommend careful monitoring of liver function throughout iguratimod treatment for diseases.

References

Mar 23, 2000·Journal of Hepatology·D Larrey
May 29, 2009·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·M Isabel LucenaUNKNOWN Spanish Group for the Study of Drug-Induced Liver Disease
Dec 19, 2013·Experimental and Therapeutic Medicine·Yi LiGuozhong Gong
Feb 1, 2007·Frontiers of Medicine in China·Lei LiJiyao Wang
Apr 8, 2014·Gastroenterology·Mercedes Robles-DiazUNKNOWN Safer and Faster Evidence-based Translation Consortium
Jun 1, 2014·Seminars in Liver Disease·Naga Chalasani, Paul H Hayashi
Jun 18, 2014·The American Journal of Gastroenterology·Naga P ChalasaniUNKNOWN Practice Parameters Committee of the American College of Gastroenterology
Mar 24, 2015·Expert Review of Clinical Immunology·Keiichi TanakaMasako Hara
Dec 30, 2015·International Journal of Molecular Sciences·Gaby Danan, Rolf Teschke

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Methods Mentioned

BETA
biopsy

Software Mentioned

RUCAM

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