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Acute liver failure with
concurrent bupropion and carbimazole therapy.
Khoo
AL, Tham LS, Lee KH, Lim GK.
Department of Pharmacy, National
University Hospital, Singapore. Khooal@nuh.com.sg
OBJECTIVE: To
report a case of fatal liver failure possibly associated with concurrent
use of bupropion and carbimazole. CASE SUMMARY: A 41-year-old Chinese
man with a history of hyperthyroidism had been treated with carbimazole
and propranolol for the past 5 years. He received a 10-day course of
bupropion as an aid for smoking cessation 10 weeks prior to
presentation. He developed acute liver failure with rapid deterioration
of renal function. Liver biopsy showed evidence of nonspecific
drug-induced acute liver injury. His condition was further complicated
by sepsis and coagulopathy. Death resulted 19 days after the onset of
symptoms. The likelihood that bupropion induced hepatotoxicity in our
patient was possible, based on the Naranjo probability scale.
DISCUSSION: Although there is increasing evidence of hepatotoxicity
induced by bupropion, this is the first case of fatality that could have
resulted from acute liver failure in a patient receiving bupropion while
on concomitant treatment with carbimazole. CONCLUSIONS: Clinicians
should be aware of the possibility of acute liver insult induced by
bupropion given concurrently with other hepatotoxic
drugs.
Publication Types:
PMID: 12549952 [PubMed - indexed for
MEDLINE]
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