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Published online: 2024-03-13

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Gemcitabine-related fatal cholestatic hepatitis

Oguzhan Yildiz1, Melek Karakurt Eryilmaz1, Ali Fuat Gürbüz1, Muzaffer Ugrakli1, Seda Tas Ayçiçek2, Murat Araz1, Mehmet Artaç1


Introduction. Gemcitabine is used in treatment of such cancers as pancreatic cancer and biliary tract cancer and has been shown to improve progression-free survival in patients with pancreatic cancer when administered as adjuvant chemotherapy. Low-grade elevations in liver enzymes are generally among the known toxicities of gemcitabine. However, it has also been associated with serious and fatal hepatic failure. 

Case report. A 71-year-old male patient with pancreatic cancer developed fatal cholestatic hepatitis after six cycles of gemcitabine given as adjuvant chemotherapy. 

Management and outcome. A fatal gemcitabine-associated cholestatic hepatitis in a patient receiving adjuvant gemcitabine monotherapy for pancreatic cancer. 

Discussion. Our case differs from those reported in the literature. In our patient, 10 days after the 6th course of gemcitabine administration, elevated liver enzymes, increased bilirubin, and jaundice were observed. Gemcitabine-induced cholestatic hepatitis was diagnosed because there was no other drug use that could have triggered this reaction. 

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