scholarly journals Repaglinide induced Acute Hepatotoxicity

2009 ◽  
Vol 48 (174) ◽  
pp. 162-4 ◽  
Author(s):  
Suresh Jaiswal ◽  
R Mehta ◽  
M Musuku ◽  
L Tran ◽  
Jr W McNamee

Repaglinide is considered a safe drug; adverse events are mild to moderate which includes hypoglycemia, headache, nausea, vomiting, diarrhea and dyspepsia as similar to sulphonylureas. This case report describes a rare side effect of repaglinide. In rare cases, elevated liver enzymes have been noted. We report a case of acute hepatotoxicity in a 78 year old woman who developed acute hepatotoxicity while taking repaglinide.Key Words: hepatotoxicity, hypoglycemia, repaglinide,

2019 ◽  
Vol 26 (4) ◽  
pp. 1032-1036
Author(s):  
So Yi Lam ◽  
Chung-Shien Lee ◽  
Sandhya Sharma ◽  
Kit Cheng

Introduction Anti-angiogenic treatment in adjunct with chemotherapy is widely used for the treatment of various cancers. These agents inhibit vascular endothelial growth factor (VEGF) signaling thereby inhibiting tumor proliferation and invasion. Dysphonia, or voice changes, has been documented, but is an underreported side effect of anti-angiogenic agents. We report a case of intermittent dysphonia in a patient with metastatic, platinum-refractory ovarian cancer treated with bevacizumab. Case report A 48-year-old female with high grade mixed type ovarian adenocarcinoma and concurrent left sided breast cancer was transitioned to palliative therapy with gemcitabine-bevacizumab for her ovarian cancer. At a follow-up visit after three cycles of the new therapy, the patient complained of intermittent changes in her voice, describing periods of hoarseness or softness in her voice after the chemotherapy—sometimes to the point that her voice was inaudible. Management and outcome: A new pelvic thrombus was discovered upon assessment of the patient’s disease. Bevacizumab was held and she was referred to ear, nose, and throat evaluation for dysphonia. Laryngoscopic examination showed normal vocal cord, with normal movements and no lesion or necrosis. During subsequent follow-up, the patient reported improvement in her voice with no additional dysphonia. Discussion Vocal adverse effects of anti-VEGF agents have been documented in landmark trials and case reports; however, clinicians are often unaware of this rare side effect. Although VEGF-induced dysphonia may be rare and may not impede the patient’s quality of life in some cases, it is critical to acknowledge and not underestimate this adverse effect.


Author(s):  
Shweta Pradhan ◽  
Somen Bhattacharjee

HELLP is an acronym that refers to a syndrome characterized by Haemolysis with a microangiopathic blood smear, Elevated Liver enzymes, and a Low Platelet count.  Recent studies suggested that some women will develop HELLP without the manifestations of classical symptoms. Authors present the case of a 22-year-old normotensive primigravida who went into severe thrombocytopenia and haemolysis leading to DIC, finally the diagnosis of normotensive HELLP syndrome was made. Present case report attempts to illustrate the diagnostic dilemma that a clinician faces in diagnosing an atypical presentation of HELLP syndrome. Management of jaundice during pregnancy especially in third trimester remains a dilemma for the obstetrician because of its varied aetiology, unpredictable prognosis and guarded perinatal outcome. Authors therefore recommend a rational stepwise approach toward the diagnosis of HELLP syndrome and its atypical presentation.


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