Z Gastroenterol 2012; 50(8): 771-775
DOI: 10.1055/s-0031-1299443
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Acute Liver Failure Following Minocycline Treatment – A Case Report and Review of the Literature

Akutes Leberversagen nach Therapie mit Minocyclin – Fallvorstellung und Literaturzusammenschau
A. Kuhn
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
C. Weiler-Normann
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
C. Schramm
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
S. Kluge
2   Intensive Care Department, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
M. J. Behne
3   Department of Dermatology and Venerology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
A. W. Lohse
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
,
D. Benten
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

19 December 2010

03 March 2012

Publication Date:
15 August 2012 (online)

Abstract

We present the case of a 23-year-old female patient with acute liver failure following intake of minocycline. This patient had severe hypereosinophilia and massively increased IgE levels. Experimental studies in this case revealed elevated IFN-γ-, as well as TNF-α-producing CD4+ and CD8+ T-cells after in vitro stimulation with minocycline, indicating a type I/IgE-mediated as well as type II/cytotoxic reaction in the pathogenesis of minocycline-induced liver failure. Although mild forms of liver involvement are well known side effects of minocycline, only 8 cases with acute liver failure have been reported, and we present a review of all cases.

Zusammenfassung

Wir präsentieren den Fall einer 23-jährigen Patientin mit akutem Leberversagen nach Einnahme von Minocyclin. Die Patientin zeigte eine schwere Eosinophilie und ein massiv erhöhtes IgE. In-vitro-Versuche mit mononukleären Zellen aus dem Blut der Patientin ergaben erhöhte IFN-γ und TNF-α produzierende CD4+- und CD8+ T-Zellen nach Stimulation mit Minocyclin und damit sowohl eine Typ-I-/IgE-vermittelte als auch eine Typ II/zytotoxische Reaktion in der Pathophysiologie des Minocyclin-induzierten akuten Leberversagens. Obwohl leichte Formen der Leberbeteiligung nach Einnahme von akutem Leberversagen gut bekannt sind, wurden bislang nur 8 Fälle von akutem Leberversagen dokumentiert und wir präsentieren eine Zusammenschau aller Fälle.

 
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