Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature

Background. Methylphenidate (MPH) is widely used in treating children with attention-deficit-hyperactivity disorder. Hepatotoxicity is a rare phenomenon; only few cases are described with no liver failure. Case. We report on the case of a 12-year-old boy who received MPH for attention-deficit-hypera...

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Main Authors: Hoi Y. Tong, Carmen Díaz, Elena Collantes, Nicolás Medrano, Alberto M. Borobia, Paloma Jara, Elena Ramírez
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2015/437298
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author Hoi Y. Tong
Carmen Díaz
Elena Collantes
Nicolás Medrano
Alberto M. Borobia
Paloma Jara
Elena Ramírez
author_facet Hoi Y. Tong
Carmen Díaz
Elena Collantes
Nicolás Medrano
Alberto M. Borobia
Paloma Jara
Elena Ramírez
author_sort Hoi Y. Tong
collection DOAJ
description Background. Methylphenidate (MPH) is widely used in treating children with attention-deficit-hyperactivity disorder. Hepatotoxicity is a rare phenomenon; only few cases are described with no liver failure. Case. We report on the case of a 12-year-old boy who received MPH for attention-deficit-hyperactivity disorder. Two months later the patient presented with signs and symptoms of hepatitis and MPH was discontinued, showing progressive worsening and developing liver failure and a liver transplantation was required. Other causes of liver failure were ruled out and the liver biopsy was suggestive of drug toxicity. Discussion. One rare adverse reaction of MPH is hepatotoxicity. The review of the literature shows few cases of liver injury attributed to MPH; all of them recovered after withdrawing the treatment. The probable mechanism of liver injury was MPH direct toxicity to hepatocytes. In order to establish the diagnosis of MPH-induced liver injury, we used CIOMS/RUCAM scale that led to an assessment of “possible” relationship. This report provides the first published case of acute MPH-induced liver failure with successful hepatic transplantation. Conclusions. It is important to know that hepatotoxicity can occur in patients with MPH treatment and monitoring the liver’s function is highly recommended.
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spelling doaj-art-43f0ab5b6d4747edb6471cc36bca6b932025-08-20T03:36:02ZengWileyCase Reports in Pediatrics2090-68032090-68112015-01-01201510.1155/2015/437298437298Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the LiteratureHoi Y. Tong0Carmen Díaz1Elena Collantes2Nicolás Medrano3Alberto M. Borobia4Paloma Jara5Elena Ramírez6Department of Clinical Pharmacology, Hospital Universitario La Paz, IdiPaz, School of Medicina, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, SpainPediatric Hepatology Department, Hospital Universitario La Paz, IdiPaz, Paseo de la Castellana 261, 28046 Madrid, SpainPathological Anatomy Department, Hospital Universitario La Paz, IdiPaz, Paseo de la Castellana 261, 28046 Madrid, SpainDepartment of Clinical Pharmacology, Hospital Universitario La Paz, IdiPaz, School of Medicina, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, SpainDepartment of Clinical Pharmacology, Hospital Universitario La Paz, IdiPaz, School of Medicina, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, SpainPediatric Hepatology Department, Hospital Universitario La Paz, IdiPaz, Paseo de la Castellana 261, 28046 Madrid, SpainDepartment of Clinical Pharmacology, Hospital Universitario La Paz, IdiPaz, School of Medicina, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, SpainBackground. Methylphenidate (MPH) is widely used in treating children with attention-deficit-hyperactivity disorder. Hepatotoxicity is a rare phenomenon; only few cases are described with no liver failure. Case. We report on the case of a 12-year-old boy who received MPH for attention-deficit-hyperactivity disorder. Two months later the patient presented with signs and symptoms of hepatitis and MPH was discontinued, showing progressive worsening and developing liver failure and a liver transplantation was required. Other causes of liver failure were ruled out and the liver biopsy was suggestive of drug toxicity. Discussion. One rare adverse reaction of MPH is hepatotoxicity. The review of the literature shows few cases of liver injury attributed to MPH; all of them recovered after withdrawing the treatment. The probable mechanism of liver injury was MPH direct toxicity to hepatocytes. In order to establish the diagnosis of MPH-induced liver injury, we used CIOMS/RUCAM scale that led to an assessment of “possible” relationship. This report provides the first published case of acute MPH-induced liver failure with successful hepatic transplantation. Conclusions. It is important to know that hepatotoxicity can occur in patients with MPH treatment and monitoring the liver’s function is highly recommended.http://dx.doi.org/10.1155/2015/437298
spellingShingle Hoi Y. Tong
Carmen Díaz
Elena Collantes
Nicolás Medrano
Alberto M. Borobia
Paloma Jara
Elena Ramírez
Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature
Case Reports in Pediatrics
title Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature
title_full Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature
title_fullStr Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature
title_full_unstemmed Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature
title_short Liver Transplant in a Patient under Methylphenidate Therapy: A Case Report and Review of the Literature
title_sort liver transplant in a patient under methylphenidate therapy a case report and review of the literature
url http://dx.doi.org/10.1155/2015/437298
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