Abstract
A 53-year-old postmenopausal woman, who had a family history of cryptogenic liver cirrhosis, was diagnosed with osteoporosis, and started on the selective estrogen receptor modulator (SERM) raloxifene 60 mg/day orally. She developed marked liver dysfunction. Her body mass index (BMI) was 26.5. Her blood chemistry indicated AST 342 IU/L, ALT 356 IU/L, and hyaluronic acid 255 ng/mL. An oral glucose tolerance test showed impaired glucose tolerance with marked insulin resistance. Histologically, we diagnosed this case as having pre-cirrhotic nonalcoholic steatohepatitis (NASH). This is the first histologically confirmed case of NASH that was aggravated by raloxifene.
MeSH terms
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Alanine Transaminase / blood
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Aspartate Aminotransferases / blood
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Chemical and Drug Induced Liver Injury / complications
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Chemical and Drug Induced Liver Injury / pathology*
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Chemical and Drug Induced Liver Injury / physiopathology
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Fatty Liver / chemically induced*
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Fatty Liver / complications
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Fatty Liver / pathology*
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Fatty Liver / physiopathology
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Female
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Glucose Intolerance / chemically induced
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Humans
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Insulin Resistance
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Liver / enzymology
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Liver / physiopathology
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Liver Cirrhosis / etiology
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Middle Aged
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Osteoporosis, Postmenopausal / drug therapy
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Raloxifene Hydrochloride / adverse effects*
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Raloxifene Hydrochloride / therapeutic use
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Risk Factors
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Selective Estrogen Receptor Modulators / adverse effects*
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Selective Estrogen Receptor Modulators / therapeutic use
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Severity of Illness Index
Substances
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Selective Estrogen Receptor Modulators
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Raloxifene Hydrochloride
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Aspartate Aminotransferases
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Alanine Transaminase