Tolga KÖŞECİ, Ümit KARABULUT, Bünyamin SARITAŞ, Serkan YARAŞ, Fehmi ATEŞ, ENGİN ALTINTAŞ, Orhan SEZGİN

Ornidazol’e bağı karaciğer toksisitesi: İki olgu sunumu

Ornidazol günlük uygulamalarda sık kullanılan, nitroimidazol türevi an- tibiyotiklerdendir. Ornidazole bağlı toksik hepatit nadir olarak görül- mekte olup fakat ciddi sonuçları olabilen bir durumdur. Akut karaciğer hasarı ilaca bağlı karaciğer hasarının en sık görülen biçimidir ve akut hepatitilerin %10’luk kısmını oluflturur. Kliniğimizde ornidazol kullanı- mına ikincil toksik hepatit tanısı koyduğumuz iki olguyu sunuyoruz.

Ornidazole-induced liver toxicity: Report of two cases

Ornidazole is one of the nitroimidazole-derivative antibiotics and is of- ten used in daily practice. Hepatotoxicity caused by ornidazole is rare, but when it occurs, it can have serious results. Acute liver injury is the most common type of drug-induced hepatitis and accounts for 10% of acute hepatitis. Here, we report two cases of drug-induced hepati- tis caused by ornidazole.

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1. Koch-Weser J, Goldman P. Drug therapy: metronidazole. N Engl J Med 1980;303:1212-8.
2. Koflar Y, fiaflmaz N, O¤uz P, et al. Ornidazole-induced autoimmune hepatitis. Eur J Gastroenterol Hepatol 2001;13:737-9.
3. Ersöz G, Karasu Z, Akarca US, et al. Nitroimidazole-induced chronic hepatitis. Eur J Gastroenterol Hepatol 2001;13:963-6.
4. Tabak F, Özaras R, Erzin Y, et al. Ornidazole induce liver damage: report of three cases and review of the literature. Liver International 2003:23:351-4.
5. Sgro C, Clinard F, Ouazir K, et al. Incidence of drug-induced hepatic injuries: a French population-based study. Hepatology 2002;36:451-5.
6. Shapiro MA, Lewis JH. Causality assessment of drug-induced hepatotoxicity: promises and pitfalls. Clin Liver Dis 2007;11:477-505.
7. Friis H, Andreasen PB. Drug-induced hepatic injury: an analysis of 1100 cases reported to the Danish Committee on Adverse Drug Reactions between 1978 and 1987. J Intern Med 1992;232:133-8.
8. Pillans PI. Drug associated hepatic reactions in New Zealand: 21 years experience. N Z Med J 1996;109:315-9.
9. Larrey D. Epidemiology and individual susceptibility to adverse drug reactions affecting the liver. Semin Liver Dis 2002;22:145-55.
10. Chalasani N, Fontana RJ, Bonkovsky HL, et al. Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology 2008;135:1924- 34.
11. Bell LN, Chalasani N. Epidemiology of idiosyncratic drug-induced liver injury. Semin Liver Dis 2009;29:337-47.
12. Chang CY, Schiano TD. Review article: drug hepatotoxicity. Aliment Pharmacol Ther 2007;25:1135-51.
13. Björnsson E. Drug-induced liver injury: Hy's rule revisited. Clin Pharmacol Ther 2006;79:521-8.
14. Reuben A. Hy's law. Hepatology 2004; 39:574-8.
15. Zimmerman HJ. Drug-induced liver disease. Clin Liver Dis 2000;4:73-96.
16. Benichou C. Criteria of drug-induced liver disorders.Report of an International Consensus Meeting. J Hepatol1990;11:272-6.
17. Gearhart M O. Worsening of liver function with fluconazole and review of azole antifungal hepatotoxicity. Ann Pharmacother 1994;28:1177-81.
18. Garcia Rodriguez L A, Duque A, Castellsague J, et al. A cohort study on the risk of acute liver injury among users of ketoconazole and other antifungal drugs. Br J Clin Pharmacol 1999;48:847-52.
19. Hay RJ. Risk/benefit ratio of modern antifungal therapy. Focus on hepatic reactions. J Am Acad Dermatol 1993;29:S50-4
20. Chien RN, Yang LJ, Lin PY, Liaw YF. Hepatic injury during ketoconazole therapy in patients with onychomycosis: a controlled cohort study. Hepatology 1997;25:103-7.