Ursodeoxycholic Acid Can Improve Liver Transaminase Quantities in Children with Anticonvulsant Drugs Hepatotoxicity: a Pilot Study
Abstract
The present study has been directed to investigate Ursodeoxycholic Acid (UDCA) effect in children, to reduce the high Liver transaminases induced by Anticonvulsant drugs (drug induced hepatitis). This idea has been driven from Cytoprotective and antioxidant properties of UDCA to be used in drug induced inflammation in Liver. Twenty two epileptic patients aged between 4 mo - 3 yr whom were under anticonvulsant therapy with drugs such as valperoic acid, primidone, levetiracetam, Phenobarbital or any combination of them and had shown Liver transaminases rise , after rule out of Viral-Autoimmune, Metabolic and Anatomic causes, have been prescribed UDCA in dose of 10-15 mg/kg/day, at least for 6 months. Any patient who have shown confusing factors such as genetic disorders with liver involvement or spontaneous decline in enzymes or had not treatment compliance has been excluded from the study. Transaminases range changes as well as Probable side effects of the drug have been monitored. The results indicated that UDCA is effective and well tolerable in the children with drug induced hyper transaminasemia. No side effect has been seen and recorded in this study. Based on this study and its results, we recommend UDCA as a safe and effective choice in drug induced hepatotoxicities.
Roberts Eve A. Drug induced liver disease. In: Suchy FJ, Sokol RJ, editors. Liver Disease in Children. 3rd ed. New York: Cambridge university press; 2007: p. 478-500
Ikegami T, Matsuzaki Y. Ursodeoxycholic acid:Mechanism of action and Novel clinical applications. Hepatol Res 2008;38(2):123-31.
Gamboa A, Tian C, Massad J, et al. The therapeutic role of ursodeoxycholic acid in digestive diseases. Ann Gastroenterol Hepatol 2011;2(1):43-8.
Teschke R. Drug induced Liver diseases. Z Gastroenterol 2002;40(5):305-26.
Bertolotti M, Morselli labate AM, Rusticali AG, et al. Ursodeoxycholic acid improves liver tests in chronic hepatitis – Results of a randomized controlled trial. Clin Drug Investig 1999;17(6):425-34.
Chamulitrat W, Burhenne J, Rehlen T, et al. Bile salt – phospholipid conjugate ursodeoxycholyl lysophosphatidyl ethanolamide as a hepatoprotective agent. Hepatology 2009;50(1):143-54.
Lapenna D, Ciofani G, Festi D, et al. Antioxidant properties of ursodeoxycholic acid. Biochem Pharmacol 2002;64(11):1661-7.
Soza A, Riquelme F, Alvarez M, et al. Hepatotoxicity by Amoxicillin/ Clavulanic acid: case report. Rev Med de Chile 2000;127(12):1487-91.
Dandakis D, Petrogiannopoulos C, Hartzoulakis G, et al. Cholestatic hepatitis associated with amoxicillin – clavulanic acid combination. A case report. Ann Gastroenterol 2002;15(1):85-7.
Manolakopoulos S, Bethanis S, Armonis A, et al. Toxic hepatitis after sequential administration of Flutamide and Cyproterone Acetate. Dig Dis Sci 2004;49(3):462-5.
Cicognani C, Malavolti M, Morselli-Labate A, et al. Flutamide induced toxic hepatitis , potential utility of Ursodeoxycholic acid administration in toxic hepatitis. Dig Dis Sci 1996;41(11):2219-21.
Stickel F, Droz S, Patasenker E, et al. Severe hepatotoxicity following ingestion of Herbalife nutritional supplements contaminated with Bacillus Subtilis. J Hepatol 2009;50(1):111-7.
El-Sherbiny GA, Taye A, Abdel-Raheem IT. Role of ursodeoxycholic acid in prevention of hepatotoxicity caused by amoxicillin – clavulanic acid in rats. Ann Hepatol 2009;8(2):134-40.
Uraz S, Tahan V, Aygun C, et al. Role of Ursodeoxycholic acid in prevention of Methotrexate-induced liver toxicity. Dig Dis Sci 2008;53(4):1071-7.
Files | ||
Issue | Vol 53, No 6 (2015) | |
Section | Original Article(s) | |
Keywords | ||
Ursodeoxycholic acid Liver transaminases Drug induced hepatitis Anticonvulsant drugs |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |