Selective estrogen receptor modulator raloxifene-associated aggravation of nonalcoholic steatohepatitis

Intern Med. 2007;46(9):579-81. doi: 10.2169/internalmedicine.46.6374. Epub 2007 May 1.

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.

Publication types

  • Case Reports

MeSH terms

  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Chemical and Drug Induced Liver Injury / complications
  • Chemical and Drug Induced Liver Injury / pathology*
  • Chemical and Drug Induced Liver Injury / physiopathology
  • Fatty Liver / chemically induced*
  • Fatty Liver / complications
  • Fatty Liver / pathology*
  • Fatty Liver / physiopathology
  • Female
  • Glucose Intolerance / chemically induced
  • Humans
  • Insulin Resistance
  • Liver / enzymology
  • Liver / physiopathology
  • Liver Cirrhosis / etiology
  • Middle Aged
  • Osteoporosis, Postmenopausal / drug therapy
  • Raloxifene Hydrochloride / adverse effects*
  • Raloxifene Hydrochloride / therapeutic use
  • Risk Factors
  • Selective Estrogen Receptor Modulators / adverse effects*
  • Selective Estrogen Receptor Modulators / therapeutic use
  • Severity of Illness Index

Substances

  • Selective Estrogen Receptor Modulators
  • Raloxifene Hydrochloride
  • Aspartate Aminotransferases
  • Alanine Transaminase