technetium-tc-99m-mebrofenin and grazoprevir

There is a growing interest in assessment of future remnant liver function with Tc-mebrofenin hepatobiliary scintigraphy before major hepatectomy to estimate the risk of posthepatectomy liver failure. We illustrate the case of a 42-year-old woman with liver metastasis from colorectal cancer who performed hepatobiliary scintigraphy. Tc-mebrofenin clearance rate of the total liver was considerably low. The patient recently started a treatment for active hepatitis C with a combination of 2 new direct-acting antiviral agents (grazoprevir, elbasvir). Apart from hypoalbuminemia or hyperbilirubinemia, physicians must be aware that drug interactions can interfere with Tc-mebrofenin liver uptake, thereby resulting in a dramatic underestimation of liver function.

Topics: Adult; Amides; Aniline Compounds; Antiviral Agents; Benzofurans; Carbamates; Cyclopropanes; Drug Interactions; Female; Glycine; Hepacivirus; Humans; Imidazoles; Imino Acids; Liver Failure; Organotechnetium Compounds; Quinoxalines; Radionuclide Imaging; Radiopharmaceuticals; Sulfonamides