Ahead of print
Case report
Published online: 2024-03-13

open access

Page views 96
Article views/downloads 22
Get Citation

Connect on Social Media

Connect on Social Media

Gemcitabine-related fatal cholestatic hepatitis

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

Abstract

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. 

Article available in PDF format

View PDF Download PDF file

References

  1. Aapro MS, Martin C, Hatty S. Gemcitabine--a safety review. Anticancer Drugs. 1998; 9(3): 191–201.
  2. Fischer J, Ganellin CR. Analogue-based Drug Discovery. Chemistry International -- Newsmagazine for IUPAC. 2010; 32(4).
  3. Oettle H, Neuhaus P. Adjuvant therapy in pancreatic cancer: a critical appraisal. Drugs. 2007; 67(16): 2293–2310.
  4. Okada S, Ueno H, Okusaka T, et al. Phase I trial of gemcitabine in patients with advanced pancreatic cancer. Jpn J Clin Oncol. 2001; 31(1): 7–12.
  5. Ostapowicz G, Lee WM. Acute hepatic failure: a Western perspective. J Gastroenterol Hepatol. 2000; 15(5): 480–488.
  6. Stirnimann G, Kessebohm K, Lauterburg B. Liver injury caused by drugs: an update. Swiss Med Wkly. 2010; 140: w13080.
  7. Coeman DC, Verbeken EK, Nackaerts KL, et al. A fatal case of cholestatic liver failure probably related to gemcitabine. Ann Oncol. 2000; 11(11): 1503.
  8. Kagohashi K, Funayama Y, Satoh H, et al. Fatal hepatic failure due to gemcitabine and vinorelbine. Ann Oncol. 2003; 14(6): 960.
  9. Matsuda M, Watanabe G, Mine S, et al. [Fatal liver failure associated with gemcitabine hydrochloride therapy]. Gan To Kagaku Ryoho. 2008; 35(1): 157–159.
  10. Samlowski WE, Gundacker H, Kuebler JP, et al. Evaluation of gemcitabine in patients with recurrent or metastatic squamous cell carcinoma of the head and neck: a Southwest Oncology Group phase II study. Invest New Drugs. 2001; 19(4): 311–315.
  11. Robinson K, Lambiase L, Li J, et al. Fatal cholestatic liver failure associated with gemcitabine therapy. Dig Dis Sci. 2003; 48(9): 1804–1808.
  12. Dobbie M, Hofer S, Oberholzer M, et al. Veno-occlusive disease of the liver induced by gemcitabine. Ann Oncol. 1998; 9(6): 681.