Acute Hepatitis Induced by Cyproterone Acetate

Abstract

OBJECTIVE:

To report a case of acute hepatitis resulting from the use of cyproterone acetate, an adjuvant treatment for prostate cancer.

CASE SUMMARY:

An 87-year-old white man, admitted to surgery for prostate cancer, received cyproterone acetate 300 mg/d orally and developed acute hepatitis, which initially was diagnosed clinically. A liver biopsy showed changes suggestive of acute cholestatic hepatitis. Cyproterone was stopped immediately, and the patient was subsequently treated with corticosteroids. He then improved rapidly.

DISCUSSION:

Cyproterone acetate is thought to be well tolerated, but some authors have reported severe hepatic reactions, in particular acute hepatitis, fatal fulminant hepatic failure, and hepatocellular carcinoma. The above-mentioned hepatotoxicity represents an idiosyncratic drug reaction, probably due to the hepatomitogen action of cyproterone, causing an increase of hepatocytes expressing placental glutathione S-transferase, which are considered preneoplastic elements.

CONCLUSIONS:

This case suggests the possibility of hepatotoxicity from cyproterone.