ABSTRACT

Elevation in hepatic enzymes during the course of malignant hematological di-seases may cause diagnostic difficulty. Here we present a patient who develo-ped severe hepatotoxicity due to cytosine arabinoside (Ara-C) for treatment of acute myeloid leukemia. In the majority of patients, several drugs were used to-gether with Ara-C during the course of treatment and blood transfusions were given. Therefore, it was difficult to differentiate which caused the hepatotoxi-city. In our patient, hepatic damage might be related to Ara-C and other drugs such as sefepim, amikacin, meropenem, teicoplanin, and amphotericin B used in the first combination treatment. In conclusion, serious hepatotoxicity mimic-king acute hepatitis may develop due to Ara-C for treatment of acute leukemia. However, in the second consolidation treatment, Ara-C was the only drug used and there were no other antibiotic or antifungal drugs. The elevation in hepatic enzymes was higher in the first combination treatment than in the second con-solidation treatment with Ara-C. Therefore, hepatotoxicity due to Ara-C should also be considered in the differential diagnosis in leukemic patients with seve-re hepatic dysfunction.