Abstract

BackgroundFenofibrate is commonly used in the treatment of dyslipidemia. Fenofibrate is related to mild aminotransferase elevations and in some cases severe chronic injury such as fibrosis or cirrhosis, resulting in liver transplantation or death. The latency of disease has been reported to range between weeks to years.Case presentationA 63 years old male with hypertriglyceridemia developed symptoms of fatigue and anorexia 48 h after taking fenofibrate for the first time. The patient’s aminotransferase level was more than 10 times ULN. Immediately, fenofibrate was discontinued and aminotransferase level returned to normal 23 days later. To assess causality between the drug and liver damage, the standardized Roussel Uclaf Causality Assessment Method (RUCAM) was used. The patient's RUCAM score was 7, which fell in the group of “probable”. Eight months later, follow-up examination suggested the liver function was normal.ConclusionsWeakness, fatigue and abnormal liver function during fenofibrate therapy should be closely monitored and trigger prompt withdrawal if these symptoms occur.

Highlights

  • Fenofibrate is commonly used in the treatment of dyslipidemia

  • Fenofibrate is a peroxisome proliferator receptor alpha (PPAR-α) activator which is commonly used in the therapy of hypertriglyceridemia and mixed dyslipidemia

  • Transient serum aminotransferase elevations may develop in up to 20% of patients receiving fenofibrate

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Summary

Introduction

Fenofibrate is commonly used in the treatment of dyslipidemia. Fenofibrate is related to mild ami‐ notransferase elevations and in some cases severe chronic injury such as fibrosis or cirrhosis, resulting in liver trans‐ plantation or death. Conclusions: Weakness, fatigue and abnormal liver function during fenofibrate therapy should be closely monitored and trigger prompt withdrawal if these symptoms occur. Transient serum aminotransferase elevations may develop in up to 20% of patients receiving fenofibrate. Patients may develop severe chronic injury such as fibrosis or cirrhosis, which could lead to liver transplantation or death [1].

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