1 research outputs found
Pegvisomant-Induced Cholestatic Hepatitis in an Acromegalic Patient with UGT1A1∗ 28 Mutation
Pegvisomant (PEGv) is a growth hormone receptor antagonist approved for the treatment of acromegaly; one of its documented
adverse effects is reversible elevation of hepatic enzymes. We report a 39-year-old male acromegalic patient with a pituitary
macroadenoma who underwent transsphenoidal surgery. The patient’s condition improved but GH and IGF-I levels did not
normalize; as a consequence, we first administered dopamine agonists and then somatostatin receptor ligands (SRLs) with poor
response. PEGv 15mg every other day was added to lanreotide 120mg monthly. The patient developed a severe hepatitis five
months after starting the combination therapy. Elevated ferritin, iron, and transferrin saturation suggested probable hepatitis due
to haemochromatosis. We performed a liver biopsy which showed an acute cholestatic hepatitis consistent with toxic etiology. A
heterozygous genotype UGT1A1∗28 polymorphism associated with Gilbert’s syndrome was also found in this Argentine patient.
The predominant clinical presentation resembled an acute cholestatic hepatitis associated with severe hemosiderosis, a different
and new pattern of PEGv hepatotoxicityS