Dydrogesterone/follitropin-α/progesterone
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Reactions 1511, p19 - 26 Jul 2014 S Dydrogesterone/follitropin-α/ progesterone Hepatitis: case report A 39-year-old woman developed hepatitis while receiving dydrogesterone [Duphaston], follitropin-α [Gonal-F], and progesterone [Utrogestan]. The woman was undergoing in vitro fertilization (IVF) treatment for her primary subfertility. She had received two previous IVF cycles without experiencing jaundice. For her third IVF cycle, ovarian stimulation was performed using follitropin-α [Gonal-F] 225 IU [route not stated] from day 2 until day 12 (11 days) with the addition of ganirelix on day 8 until trigger day on day 12. On trigger day 12, she received choriogonadotropin-α with retrieval of the oocytes performed on day 14. Luteal support was provided with oral dydrogesterone 10mg thrice a day and per vaginal progesterone 100mg thrice a day, in addition to SC chorionic gonadotropin. The woman reported pruritus all over her body especially on her palms and soles and increasing jaundice 10 days after embryo transfer. She underwent a series of laboratory investigations which revealed raised bilirubin level and elevated liver enzymes. Her radiological investigation was unremarkable. She was diagnosed with hepatitis. A provisional diagnosis of drug-induced hepatitis was eventually made. The woman’s jaundice lasted for almost 2 months. She was treated with ursodeoxycholic acid and lactulose which resolved her jaundice. Her bilirubin and liver enzymes gradually normalised and medication ended. Author comment: "A potential drug induced hepatitis in this case could be due to the progesterone. Dydrogesterone- induced hepatitis was first described by Altintas et al. in 2004." "[Follitropin-α] is the other potential drug that may cause the hepatitis". Mustafa KB, et al. Severe jaundice post embryo transfer: A case report. Giornale Italiano di Ostetricia e Ginecologia 36: 229-231, No. 1, Jan-Feb 2014. Available from: URL: http://www.giog.it/index.php?PAGE=issue&ID_ISSUE=731 - Malaysia 803106160 1 Reactions 26 Jul 2014 No. 1511 0114-9954/14/1511-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Dydrogesterone/follitropin-α/progesterone
Reactions 1511, p19 - 26 Jul 2014
SDydrogesterone/follitropin-α/progesterone
Hepatitis: case reportA 39-year-old woman developed hepatitis while receiving
dydrogesterone [Duphaston], follitropin-α [Gonal-F], andprogesterone [Utrogestan].
The woman was undergoing in vitro fertilization (IVF)treatment for her primary subfertility. She had received twoprevious IVF cycles without experiencing jaundice. For herthird IVF cycle, ovarian stimulation was performed usingfollitropin-α [Gonal-F] 225 IU [route not stated] from day 2until day 12 (11 days) with the addition of ganirelix on day 8until trigger day on day 12. On trigger day 12, she receivedchoriogonadotropin-α with retrieval of the oocytes performedon day 14. Luteal support was provided with oraldydrogesterone 10mg thrice a day and per vaginalprogesterone 100mg thrice a day, in addition to SC chorionicgonadotropin. The woman reported pruritus all over her bodyespecially on her palms and soles and increasing jaundice10 days after embryo transfer. She underwent a series oflaboratory investigations which revealed raised bilirubin leveland elevated liver enzymes. Her radiological investigation wasunremarkable. She was diagnosed with hepatitis. A provisionaldiagnosis of drug-induced hepatitis was eventually made.
The woman’s jaundice lasted for almost 2 months. She wastreated with ursodeoxycholic acid and lactulose whichresolved her jaundice. Her bilirubin and liver enzymesgradually normalised and medication ended.
Author comment: "A potential drug induced hepatitis inthis case could be due to the progesterone. Dydrogesterone-induced hepatitis was first described by Altintas et al. in2004." "[Follitropin-α] is the other potential drug that maycause the hepatitis".Mustafa KB, et al. Severe jaundice post embryo transfer: A case report. GiornaleItaliano di Ostetricia e Ginecologia 36: 229-231, No. 1, Jan-Feb 2014. Availablefrom: URL: http://www.giog.it/index.php?PAGE=issue&ID_ISSUE=731 -Malaysia 803106160
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Reactions 26 Jul 2014 No. 15110114-9954/14/1511-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
