Chlorzoxazone
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Reactions 1181 - 8 Dec 2007 S Chlorzoxazone Acute liver failure: case report A 38-year-old woman developed acute liver failure while receiving chlorzoxazone for a lower back strain. The woman started receiving chlorzoxazone [Parafon Forte] 500mg twice daily. She subsequently developed progressive nausea, vomiting and scleral icterus. After about 1 month of symptoms, she presented to an emergency department with increasing confusion and lethargy. She had a serum ALT level of 1027 U/mL, a serum AST level of 846 U/mL, a bilirubin level of 19.9 mg/dL and a prothrombin time of 32.6 seconds. She was referred to another institution for evaluation; at this time, she had been receiving chlorzoxazone for 6 weeks. On examination, she had a HR of 99 beats/min, mild asterixis, profound scleral icterus, mild hepatomegaly and flank dullness consistent with ascites. An abdominal CT scan revealed a nodular-appearing liver, a small amount of ascites, and small left gastric and perisplenic varices. The hepatic vasculature and inferior vena cava were all patent. On hospital day 2, a transjugular liver biopsy was consistent with drug-induced injury. The working diagnosis was chlorzoxazone-induced liver failure. For the next 15 days, she remained in the ICU. Her transaminase levels normalised slowly. The woman underwent successful liver transplantation. Analysis of the explanted liver revealed submassive necrosis. She was discharged in good condition. Jackson J, et al. Chlorzoxazone as a cause of acute liver failure requiring liver transplantation. Digestive Diseases and Sciences 52: 3389-3391, No. 12, Dec 2007 - USA 801097822 1 Reactions 8 Dec 2007 No. 1181 0114-9954/10/1181-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Chlorzoxazone
Reactions 1181 - 8 Dec 2007
SChlorzoxazone
Acute liver failure: case reportA 38-year-old woman developed acute liver failure while
receiving chlorzoxazone for a lower back strain.The woman started receiving chlorzoxazone [Parafon Forte]
500mg twice daily. She subsequently developed progressivenausea, vomiting and scleral icterus. After about 1 month ofsymptoms, she presented to an emergency department withincreasing confusion and lethargy. She had a serum ALT levelof 1027 U/mL, a serum AST level of 846 U/mL, a bilirubin levelof 19.9 mg/dL and a prothrombin time of 32.6 seconds. Shewas referred to another institution for evaluation; at this time,she had been receiving chlorzoxazone for 6 weeks. Onexamination, she had a HR of 99 beats/min, mild asterixis,profound scleral icterus, mild hepatomegaly and flank dullnessconsistent with ascites. An abdominal CT scan revealed anodular-appearing liver, a small amount of ascites, and smallleft gastric and perisplenic varices. The hepatic vasculature andinferior vena cava were all patent. On hospital day 2, atransjugular liver biopsy was consistent with drug-inducedinjury. The working diagnosis was chlorzoxazone-inducedliver failure. For the next 15 days, she remained in the ICU. Hertransaminase levels normalised slowly.
The woman underwent successful liver transplantation.Analysis of the explanted liver revealed submassive necrosis.She was discharged in good condition.Jackson J, et al. Chlorzoxazone as a cause of acute liver failure requiring livertransplantation. Digestive Diseases and Sciences 52: 3389-3391, No. 12, Dec 2007- USA 801097822
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Reactions 8 Dec 2007 No. 11810114-9954/10/1181-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
