ArticleFrontiers in pharmacology2019
Hepatotoxicity Due to Azole Antimycotic Agents in a HLA B*35:02-Positive Patient.
Article in Frontiers in pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 11 citations in OpenAlex.
- TRIZ-guided computational innovation framework for the automated generation and prioritization of novel azole-like antifungal candidates targeting Candida auris CYP51.Journal of computer-aided molecular design · 2026Article
- Drug-Induced Liver Injury From a Novel Antifungal - Olorofim.ACG case reports journal · 2026Article
- Human leukocyte antigen pharmacogenetics in infectious diseases: anti-infective drug toxicity and host immune response.Frontiers in pharmacology · 2026Review
- Early-onset severe voriconazole-induced liver injury with progressive cholestasis in pulmonary aspergillosis: A case report.Respiratory medicine case reports · 2026Article
- Comprehensive insights into the role of nanocarriers in advancing azole-based ocular therapeutics.RSC advances · 2025Review
- Real World Posaconazole Pharmacokinetic Data in Paediatric Stem Cell Transplant Recipients.Children (Basel, Switzerland) · 2025Article
- Recent innovations and challenges in the treatment of fungal infections.Frontiers in cellular and infection microbiology · 2025Review
- Toxicity of a novel antifungal agent (ATB1651 gel) in Yucatan minipigsToxicological research · 2024Article
- Synergic Effect of Phthalide Lactones and Fluconazole and Its New Analogues as a Factor Limiting the Use of Azole Drugs against Candidiasis.Antibiotics (Basel, Switzerland) · 2022Article
- Microbial Synthesis and Evaluation of Fungistatic Activity of 3-Butyl-3-hydroxyphthalide, the Mammalian Metabolite of 3-International journal of molecular sciences · 2021Article
- Rechallenge of voriconazole successfully tolerated after hepatic toxicity.Respiratory medicine case reports · 2020Article
- Hepatotoxicity Induced by Azole Antifungal Agents: A Review Study.Iranian journal of pharmaceutical research : IJPRReview
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We will present a 42-year-old woman with acute myeloid leukemia and pulmonary aspergillosis. She was treated with several antifungal agents, including three triazoles. Voriconazole, posaconazole, and isavuconazole all led to hepatocellular liver injury. Voriconazole administration led to a peak alanine aminotransferase (ALT) value of 1,793 U/L (normal range, 9-59 U/L). After posaconazole and isavuconazole treatment, ALT rose over 500 U/L. The typical course of events, exclusion of differential diagnoses, and normalization of the liver function tests (LFTs) after stopping the triazoles were highly suspicious for a drug-induced liver injury (DILI). Interestingly, our patient carries a rare HLA B allele (HLA B*35:02), which occurs in less than 1% of the population and is known to be associated with minocycline-induced liver injury. Over the course of 4 months, the patient received two induction chemotherapies and afterward underwent a successful allogenic hematopoietic stem cell transplantation. Her liver function recovered rapidly and favorable clinical findings concerning the aspergillosis led to a de-escalation of the antifungal treatment to prophylactic dose fluconazole. Delayed hepatotoxicity suggested a dose dependency and a cumulative effect. The question of a common pathophysiology and a cross-toxicity was raised. At the present time, only a few case reports describe cross-toxicity or its absence after rechallenge with different azoles. The pathophysiology is not well understood. Ketoconazole was found to impair rat mitochondrial function
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