Sitaxsentan-Induced Acute Severe Hepatitis Treated with Glucocorticoid Therapy

• Main Authors: Marcus W Chin, Robert D Levy, Eric M Yoshida, Michael F Byrne
• Format: Article
• Language: English
• Published: Hindawi Limited 2012-01-01
• Series: Canadian Respiratory Journal
• Online Access: http://dx.doi.org/10.1155/2012/567024

Endothelin receptor antagonists are commonly used in the treatment of pulmonary hypertension. Sitaxsentan, a selective endothelin A receptor blocker, induces a mild transaminitis in approximately 3% to 5% of patients, but rarely an acute severe hepatitis. A case involving a 61-year-old female with sitaxsentan-induced acute severe liver failure is presented. Depite withdrawal of therapy, her liver tests failed to improve. After six weeks of monitoring, the patient was administered high-dose corticosteroids, with a good clinical and biochemical response. While endothelin receptor antagonists are postulated to cause hepatitis by inhibition of a bile salt transporter pump, an immune-mediated or idiosyncratic mechanism should be considered.