Acute Liver Injury during Co-treatment with Levetiracetam and Temozolomide

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Authors

  • Shmuel Chen Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  • Meir Mizrahi Division of Gastroenterology, Center for Advanced Endoscopy, Beth Israel Deaconess Medi- cal Center and Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, USA
  • Adi Nubani Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  • Jacob Olech Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  • Alexander Lossos Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  • Morde chai Muzskat Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
  • Eldad Ben-Shitrit Department of Internal Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

DOI:

https://doi.org/10.17140/lroj-1-104

Keywords:

Levetiracetam, Temozolomide, Liver injury, MGMT, Glioblastoma multiform

Abstract

Drug-induced liver injury (DILI) accounts for approximately 10 percent of all cases of acute hepatitis. The patterns of acute injury include any form of hepatic injury, but the most common problems are cholestasis, hepatocellular damage, or a mixed type. DILI is often reversible, and discontinuation of the offending agent usually results in a complete recovery; however, some cases may lead to chronic liver injury, cirrhosis, and even death. Temozolomide (TMZ) is an alkylating, anti-neoplastic agent used for the treatment of refractory anaplastic astrocytoma, newly-diagnosed Glioblastoma multiforme (GBM) and metastatic melanoma. Levetiracetam (LEV) is an established second-generation antiepileptic drug and is most commonly approved as adjunctive treatment of partial-onset seizures with or without secondary generalization. When administered separately each of these drugs is considered to be relatively safe and only few cases of severe liver injury can be found throughout the literature; however, LEV and TMZ are commonly used together in the treatment of brain malignancies. We report three patients who presented with jaundice during treatment with TMZ and LEV, and propose a mechanism for liver sensitization by LEV for TMZ-induced injury.

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Published

2015-05-05

How to Cite

Shmuel Chen, Meir Mizrahi, Adi Nubani, Jacob Olech, Alexander Lossos, Morde chai Muzskat, & Eldad Ben-Shitrit. (2015). Acute Liver Injury during Co-treatment with Levetiracetam and Temozolomide. Liver Research, 1(1), 21–25. https://doi.org/10.17140/lroj-1-104

Issue

Vol. 1 No. 1 (2015): Volume 1 Issue 1 2015

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Articles

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