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Rapid bupropion-induced hepatotoxicity: a case report and review of the literature

BACKGROUND: Bupropion is an antidepressant that is also used as a non-nicotine method to aid in smoking cessation. Bupropion-induced hepatotoxicity is quoted to affect between 0.1% and 1% of treated patients with either a hepatocellular and/or cholestatic pattern of damage. The mechanism of damage i...

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Autores principales: Anandabaskaran, Sulakchanan, Ho, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389237/
https://www.ncbi.nlm.nih.gov/pubmed/29475455
http://dx.doi.org/10.1186/s13256-018-1563-9
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author Anandabaskaran, Sulakchanan
Ho, Vincent
author_facet Anandabaskaran, Sulakchanan
Ho, Vincent
author_sort Anandabaskaran, Sulakchanan
collection PubMed
description BACKGROUND: Bupropion is an antidepressant that is also used as a non-nicotine method to aid in smoking cessation. Bupropion-induced hepatotoxicity is quoted to affect between 0.1% and 1% of treated patients with either a hepatocellular and/or cholestatic pattern of damage. The mechanism of damage is considered to be predominantly immune-mediated with the presence of a hypersensitivity syndrome (fever, rash, eosinophilia, autoantibodies) and a short latency period (1–6 weeks). We believe our reporting of this case to the already existing small list of only seven cases in the world literature will help practicing physicians to deal with the diagnostic and management dilemmas that bupropion-induced hepatotoxicity brings. CASE PRESENTATION: A 50-year-old Caucasian woman presented to our hospital with significant derangement of liver transaminases after 6 days of bupropion treatment for smoking cessation. The patient’s other medications were considered unlikely to be the cause of the hepatotoxicity and were therefore continued. The patient’s liver function tests normalized on withdrawal of bupropion, confirming that bupropion was the probable cause of the patient’s hepatotoxicity. CONCLUSIONS: We conclude that hepatotoxicity is a rare adverse effect of bupropion use, but physicians should be aware of the possibility of this potentially serious clinical picture of drug-induced hepatotoxicity with varied clinical presentation and prognosis.
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spelling pubmed-63892372019-03-19 Rapid bupropion-induced hepatotoxicity: a case report and review of the literature Anandabaskaran, Sulakchanan Ho, Vincent J Med Case Rep Case Report BACKGROUND: Bupropion is an antidepressant that is also used as a non-nicotine method to aid in smoking cessation. Bupropion-induced hepatotoxicity is quoted to affect between 0.1% and 1% of treated patients with either a hepatocellular and/or cholestatic pattern of damage. The mechanism of damage is considered to be predominantly immune-mediated with the presence of a hypersensitivity syndrome (fever, rash, eosinophilia, autoantibodies) and a short latency period (1–6 weeks). We believe our reporting of this case to the already existing small list of only seven cases in the world literature will help practicing physicians to deal with the diagnostic and management dilemmas that bupropion-induced hepatotoxicity brings. CASE PRESENTATION: A 50-year-old Caucasian woman presented to our hospital with significant derangement of liver transaminases after 6 days of bupropion treatment for smoking cessation. The patient’s other medications were considered unlikely to be the cause of the hepatotoxicity and were therefore continued. The patient’s liver function tests normalized on withdrawal of bupropion, confirming that bupropion was the probable cause of the patient’s hepatotoxicity. CONCLUSIONS: We conclude that hepatotoxicity is a rare adverse effect of bupropion use, but physicians should be aware of the possibility of this potentially serious clinical picture of drug-induced hepatotoxicity with varied clinical presentation and prognosis. BioMed Central 2018-02-24 /pmc/articles/PMC6389237/ /pubmed/29475455 http://dx.doi.org/10.1186/s13256-018-1563-9 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Anandabaskaran, Sulakchanan
Ho, Vincent
Rapid bupropion-induced hepatotoxicity: a case report and review of the literature
title Rapid bupropion-induced hepatotoxicity: a case report and review of the literature
title_full Rapid bupropion-induced hepatotoxicity: a case report and review of the literature
title_fullStr Rapid bupropion-induced hepatotoxicity: a case report and review of the literature
title_full_unstemmed Rapid bupropion-induced hepatotoxicity: a case report and review of the literature
title_short Rapid bupropion-induced hepatotoxicity: a case report and review of the literature
title_sort rapid bupropion-induced hepatotoxicity: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389237/
https://www.ncbi.nlm.nih.gov/pubmed/29475455
http://dx.doi.org/10.1186/s13256-018-1563-9
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