Canadian Respiratory Journal (Jan 2012)

Sitaxsentan-Induced Acute Severe Hepatitis Treated with Glucocorticoid Therapy

  • Marcus W Chin,
  • Robert D Levy,
  • Eric M Yoshida,
  • Michael F Byrne

DOI
https://doi.org/10.1155/2012/567024
Journal volume & issue
Vol. 19, no. 1
pp. e1 – e2

Abstract

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Endothelin receptor antagonists are commonly used in the treatment of pulmonary hypertension. Sitaxsentan, a selective endothelin A receptor blocker, induces a mild transaminitis in approximately 3% to 5% of patients, but rarely an acute severe hepatitis. A case involving a 61-year-old female with sitaxsentan-induced acute severe liver failure is presented. Depite withdrawal of therapy, her liver tests failed to improve. After six weeks of monitoring, the patient was administered high-dose corticosteroids, with a good clinical and biochemical response. While endothelin receptor antagonists are postulated to cause hepatitis by inhibition of a bile salt transporter pump, an immune-mediated or idiosyncratic mechanism should be considered.