benzarone and Hepatitis--Chronic

We report three cases of severe hepatotoxicity related to benzarone, a benzofuran derivative. Our cases include a 35-year-old woman with (sub)fulminant hepatitis, a 67-year-old woman with macronodular cirrhosis, and a 68-year-old man with severe chronic active hepatitis and cirrhosis, with positivity of anti-smooth muscle antibodies. Two patients died. We stress the potential of benzarone to cause hepatotoxicity, which usually resembles severe chronic active hepatitis. Our cases constitute the most severe cases of benzarone hepatotoxicity reported so far, and comprise the first cases of (sub)fulminant hepatitis and cirrhosis related to benzarone.

Topics: Adult; Aged; Benzbromarone; Biopsy; Chemical and Drug Induced Liver Injury; Chemical and Drug Induced Liver Injury, Chronic; Fatal Outcome; Female; Fibrinolytic Agents; Hepatic Encephalopathy; Hepatitis, Chronic; Humans; Liver; Liver Cirrhosis; Male; Thrombophlebitis; Venous Insufficiency

We report a case of chronic active hepatitis caused by benzarone, a benzofuran derivative used in Europe for the treatment of peripheral venous disorders. Jaundice and serum alanine aminotransferase activity increased while drug administration was continued, but promptly decreased when it was eventually interrupted. Liver lesions were those of chronic active hepatitis. Anti-smooth muscle antibodies were present at a titer of 1:500 and disappeared 8 months after withdrawal of benzarone.

Topics: Alanine Transaminase; Benzbromarone; Benzofurans; Chemical and Drug Induced Liver Injury, Chronic; Female; Fibrinolytic Agents; Hepatitis, Chronic; Humans; Middle Aged