Terbinafine-induced cholestatic hepatitis treated with ursodeoxycholic acid: a case report

Abstract Terbinafine is a synthetic antifungal agent commonly used for dermatophytosis, is generally well tolerated, with few adverse effects. Hepatobiliary dysfunction associated with terbinafine has been reported infrequently. We here report a patient who developed severe cholestatic hepatitis following the use of terbinafine. Pruritic symptoms and cholestatic findings of our case were resolved within six weeks after addition of Ursodeoksycholic acid (UDCA). From the review of published cases, predominant pattern of terbinafine-induced hepatic injury has been cholestatic hepatitis whereas the mechanism of hepatic injury still remains unknown. In summary; physicians should remember terbinafine as a causative agent when a patient presents cholestatic symptoms, and UDCA can be a reasonable choice to treat this type of drug-induced hepatitis. Keywords: Cholestasis, hepatitis, terbinafine, ursodeoxycholic acid Ozet Terbinafin, dermatofitozda sik kullanilan, yan etkileri az ve genellikle iyi tolere edilen sentetik bir antifungal ajandir. Terbinafine bagli hepatobiliyer patoloji nadir gorulmektedir. Burada terbinafin kullanimindan sonra ciddi kolestatik hepatit gelisen bir hasta rapor edilmistir. Vakamizda kasinti sikayetleri ve kolestatik bulgular, ursodeoksikolik asitin (UDCA) tedaviye eklenmesinden sonraki alti hafta icinde duzelmistir. Tam olarak mekanizmasi bilinmese de, onceki yayinlanmis vakalar incelendiginde terbinafine bagli hepatik hasarin genellikle kolestatik tipte oldugu gorulmektedir. Sonuc olarak kolestatik semptomlarla bir hasta basvurdugunda hekimler, bunun terbinafine bagli olabilecegini ve UDCA'nin bu tip ilaca bagli hepatitte iyi bir tedavi secenegi olabilecegini dusunmelidirler. Anahtar sozcukler: Kolestaz, hepatit, terbinafin, ursodeoxycholic acid