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2020 ; 40
(8
): 1901-1905
Nephropedia Template TP
gab.com Text
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English Wikipedia
First case of drug-induced liver injury associated with the use of tocilizumab in
a patient with COVID-19
#MMPMID32478465
Muhovi? D
; Bojovi? J
; Bulatovi? A
; Vuk?evi? B
; Ratkovi? M
; Lazovi? R
; Smolovi? B
Liver Int
2020[Aug]; 40
(8
): 1901-1905
PMID32478465
show ga
BACKGROUND AND AIMS: Tocilizumab (TCZ; interleukine-6 receptor antagonist) has
been proposed to treat severe forms of Coronavirus disease-19 (COVID-19) because
interleukine-6 plays an important role in COVID-19-induced cytokine storm.
Several clinical studies have shown very good effects of TCZ in patients with
COVID-19, with a few minor side effects reported. Only eight serious liver
injuries caused by TCZ were reported before being used in the treatment of
patients with COVID-19. Considering the significantly increased use of TCZ for
the treatment of COVID-19, we would like to warn of its rare but possible serious
hepatotoxicity, especially when used together with other hepatotoxic drugs.
METHODS: We describe a patient with COVID-19-induced cytokine storm who developed
drug-induced liver injury associated with the use of TCZ. RESULTS: One day after
TCZ administration, serum transaminase levels increased 40-fold. Nevertheless,
TCZ had a positive effect on clinical and laboratory parameters in cytokine
storm, with transaminases values normalizing in 10 days. CONCLUSIONS: This is the
first reported case of DILI caused by TCZ in a COVID-19 patient. Intensive liver
function monitoring is imperative in COVID-19 patients, because of frequent
polypharmacy with potentially hepatotoxic drugs.