Fatal acute hepatic failure induced by danazol in a patient with endometriosis and aplastic anemia

Hayashi T, T Hayashi, Toshiaki Hayashi, Takahashi T, T Takahashi, Tohru Takahashi, Minami T, Takae Minami, T Minami, J Akaike, Jun Akaike, Akaike J, Kasahara K, K Kasahara, Kaoru KASAHARA, Adachi M, M Adachi, Masaaki Adachi, Yuji Hinoda, Y Hinoda, Hinoda Y, S Takahashi, Takahashi S, Shuji Takahashi, Hirayama T, Toyoko Hirayama, T Hirayama, Imai K, K Imai, Kohzoh Imai
Journal of gastroenterology · 2001 · vol. 36(11) , pp. 783–786 · doi:10.1007/s005350170022 · PMID:11757752 · W1987245964
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This case report describes a fatal instance of acute hepatic failure in a patient with endometriosis and aplastic anemia who was treated with danazol.

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Abstract

We describe a 47-year-old woman with severe aplastic anemia with genital bleeding who developed acute severe hepatitis after the administration of danazol while she was receiving cyclosporin. She had been diagnosed with severe aplastic anemia 1 year previously and, while hospitalized, had received methyl prednisolone pulse therapy, which was not successful. She was then referred to our hospital. She was treated with antithymocyte globulin, cyclosporin, granulocyte colony-stimulating factor, and methyl prednisolone; a good response was achieved after 3 months of this therapy. Subsequently, oral administration of cyclosporin was continued, but she was readmitted to our hospital when pancytopenia gradually developed and the genital bleeding recurred. Danazol was administered for pancytopenia and endometriosis. Four days after the first administration of danazol, epigastric pain occurred, and the danazol was stopped. Eighteen days after the first danazol administration, very severe hepatic injury occurred abruptly. The patient died of hepatic failure. Postmortem examination revealed centrilobular massive necrosis of the liver. Danazol was implicated as the agent responsible for causing the hepatic failure. Drug interactions between danazol and cyclosporin may cause adverse effects.

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Condition tags

endometriosis

MeSH descriptors

Anemia, Aplastic Danazol Endometriosis Estrogen Antagonists Liver Failure, Acute Anemia, Aplastic Anemia, Aplastic Cyclosporine Cyclosporine Danazol Danazol Endometriosis Endometriosis Estrogen Antagonists Estrogen Antagonists Fatal Outcome Female Humans Immunosuppressive Agents Immunosuppressive Agents

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References (9)

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