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Can Pantoprazole Cause Liver Failure?
Question: Can pantoprazole induce an enlarged toxic liver? If so, could this enlarged liver be the cause of obstructive jaundice in my mother, in the sense that it must be compressing the bile duct, thereby preventing the bile from entering the duodenum?
My mother has had ovarian cancer over the past three years, and had been doing well after surgery and chemotherapy (CA-125 levels 28.0 four weeks ago). However, after her last session with gemzar (end of August 2014), and while also receiving pantoprazole, she began having her direct billirubin elevated until the levels reached 11.1 mg/dl.
The apparent scenario, offered by her oncologist, of local blockage by tumor exacerbation might sound plausible, but could my hypothesis have grounds for believing that it is the enlarged liver that causes the blockage rather than the tumor?
She is having an MRI tomorrow and we (her son and she) are very concerned about what that exam will show.
I am a colleague of yours (a board-certified neurologist) and I would greatly appreciate your help.
My mother has had ovarian cancer over the past three years, and had been doing well after surgery and chemotherapy (CA-125 levels 28.0 four weeks ago). However, after her last session with gemzar (end of August 2014), and while also receiving pantoprazole, she began having her direct billirubin elevated until the levels reached 11.1 mg/dl.
The apparent scenario, offered by her oncologist, of local blockage by tumor exacerbation might sound plausible, but could my hypothesis have grounds for believing that it is the enlarged liver that causes the blockage rather than the tumor?
She is having an MRI tomorrow and we (her son and she) are very concerned about what that exam will show.
I am a colleague of yours (a board-certified neurologist) and I would greatly appreciate your help.
Brief Answer:
Some drugs can cause cholestatic hepatitis
Detailed Answer:
Hi, thank you for using Healthcare Magic. Cholestatic hepatitis can occur with various drugs and lead to an increasing bilirubin. This is not necessarily from the liver being enlarged per se, but is due to a toxic effect of the drug.
Gemzar is more likely to be the cause in your mother's case, rather than pantoprazole. It rarely can cause liver failure. So it may very well be that she is experiencing a toxic effect of drug rather than tumor blockage.
The MRI obviously would be able to tell if there is obstructing tumor. The fact that her CA-125 levels were normal just a month ago is reassuring that this is not the cause. Given that, I suspect that cholestatic hepatitis from Gemzar more likely is the cause of her jaundice. It may be necessary to use another drug if this is the case. Cholestatic jaundice may eventually clear up once a person is off the offending drug. But she needs to be watched carefully for a failing liver which could cause the jaundice and is a known (though uncommon) complication of Gemzar.
I hope this answers your query. If you have further questions, I would be happy to answer them. I wish your mother a quick recovery and resolution of this distressing situation.
Some drugs can cause cholestatic hepatitis
Detailed Answer:
Hi, thank you for using Healthcare Magic. Cholestatic hepatitis can occur with various drugs and lead to an increasing bilirubin. This is not necessarily from the liver being enlarged per se, but is due to a toxic effect of the drug.
Gemzar is more likely to be the cause in your mother's case, rather than pantoprazole. It rarely can cause liver failure. So it may very well be that she is experiencing a toxic effect of drug rather than tumor blockage.
The MRI obviously would be able to tell if there is obstructing tumor. The fact that her CA-125 levels were normal just a month ago is reassuring that this is not the cause. Given that, I suspect that cholestatic hepatitis from Gemzar more likely is the cause of her jaundice. It may be necessary to use another drug if this is the case. Cholestatic jaundice may eventually clear up once a person is off the offending drug. But she needs to be watched carefully for a failing liver which could cause the jaundice and is a known (though uncommon) complication of Gemzar.
I hope this answers your query. If you have further questions, I would be happy to answer them. I wish your mother a quick recovery and resolution of this distressing situation.
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Above answer was peer-reviewed by :
Dr. Yogesh D
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