Hepatotoxicity induced by cyproterone acetate: A report of three cases

Table 1 Patients’ laboratory values

Case	Age (yr)	Use of cyproterone acetate (mo)	Daily dose (mg)	Bilirubin (total/direct, g/L)1	AST/ALT (IU/L)2	Alkaline phospatase (IU/L)3	Albumin (g/L)4	INR5
1	82	12	200	29.5/18.4	935/535	300	3.9	1.4
2	83	7	300	10.1/9.2	721/283	350	4	2.24
3	78	3	300	30.0/25.3	505/320	380	4.2	1.2

¹Normal values (total) < 1.2 g/L, normal values (direct) < 0.4 g/L;

²Normal values < 40 IU/L;

³Normal values < 133 IU/L;

⁴Normal values > 3.5 g/L;

⁵Normal values < 1.2

Table 2 CPA-induced hepatotoxicity: review of 14 cases

Reference	Age (yr)	Liver injury	Doses (mg)	Latency (mo)	Duration1(wk)
Levesque[1]	78	ALF	200	6	2
Parys[11]	65	ALF	300	12	7
Parys[11]	83	ALF	300	15	2
Bressollette[16]	79	ALF	300	10	2
Hirsch[14]	92	ALF	100	4	5
Murphy[2]	73	ALF	100	4	Alive
Lombardi[15]	84	ALF			1
Friedmann[13]	81	ALF	300	6	7
Friedmann[13]	66	ALF	300	2	4
Giordano[10]	87	AH	300		Alive
Manolakopoulos[9]	76	AH	150	7	Alive
Savidou	82	AH	200	12	Alive
Savidou	83	AH	300	7	6
Savidou	78	AH	300	3	Alive
Mean	79.1		242.3	7.3	4
Median	80		300	6.5	4
SD	7.4		81.2	4	2.3

¹Duration between onset of jaundice and death; ALF: Acute liver failure; AH: Acute hepatitis.