Drug-Induced Acute Cholestatic Liver Damage in a Patient with Mutation of UGT1A1

Igino Rigato*; Monica Cravatari; Claudio Avellini; Euro Ponte; Saveria Lory Crocè; Claudio Tiribelli


Nat Clin Pract Gastroenterol Hepatol. 2007;4(7):403-408. 

In This Article


Flavoxate has not previously been reported as a cause of hepatotoxicity. The case patient, who had Gilbert's syndrome, received flavoxate that, in association with tibolone, might have produced a toxic effect. Several UDP-glucuronosyltransferase enzymes exist but, according to Guay et al., there is no clear indication of which is involved in flavoxate metabolism.[6]

Patients with Gilbert's syndrome mutations are relatively common (10-13% of the population).[17] Even if these patients are considered healthy, great care should be taken when a polytherapy is administered, because different drugs can be metabolized by the same glucuronosyltransferase enzyme of which the activity is reduced (as it was in this case).[18] Further studies are needed to determine whether genetic analysis of the TATA box of the UGT1A1 gene should be considered as a routine test before starting a combination therapy with a drug that is glucurono-conjugated


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