Abstract
The relationship between the pharmacokinetics of Cyclosporine A (CyA) and the hepatic function was studied in a 15-year-old woman with hepatitis. At the early stage of treatment, the values of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), and total serum bilirubin (t-Bil) were higher than the normal range, suggesting hepatic cell injury and impaired bile formation and/or duct. The blood concentration ratio of CyA metabolites (Met) to CyA was markedly decreased from 1.92 to 0.74 in accordance with the clinical improvement in liver function. In addition a significant positive correlation was demonstrated between the Met/ CyA ratio and GOT (r=0.621, p<0.05), GPT (r=0.678, p<0.02) and t-Bil (r=0.824, p<0.001), while no significant correlation were found in the concentration-to-dosage ratio of CyA and Met. These results suggest the Met/CyA ratio could be a useful indicator for evaluate the clinical response and/or hepatic function. We would like to report this as a typical case that presented on apparent correlation of Met/CyA with liver functions. These results also indicate that the Met level as well as the unchanged CyA level should be evaluated in the hepatitis patient.
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