Work

Drug-induced liver injury highly probable due to goserelin: a case report evaluated with the updated RUCAM (2016)

Year: 2025

Type: article

Abstract: Goserelin is widely used for prostate cancer, but drug-induced liver injury (DILI) has been rarely reported. We present a patient who developed ALT/AST elevations after each subcutaneous injection, followed by improvement after withdrawal and hepatoprotective therapy, with positive rechallenge upon re-exposure. By the EASL definition, the R -value was ≈6.0, indicating a hepatocellular pattern; Hy’s law was not fulfilled. Causality assessed with the updated RUCAM (2016) yielded a total score of 11, corresponding to highly probable. Although the ALT peak did not exceed 5 × ULN, the consistent temporal association and positive rechallenge prompted discontinuation/adjustment of goserelin with close biochemical follow-up, achieving a favorable outcome. This case underscores the need for vigilant monitoring—particularly with higher doses or re-exposure—and highlights the utility of R -value typing, Hy’s law, and the updated RUCAM in guiding management. Liver biopsy was not performed, representing a limitation.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1683370

Authors: Zhun Xiao, Xiqian Zhang, Longfei Zhang, Yanmin Li, Suping Ma

Institutions: First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Henan University of Traditional Chinese Medicine

Language: English

Topic: Drug-Induced Hepatotoxicity and Protection

Subfield: Pharmacology

Field: Pharmacology, Toxicology and Pharmaceutics

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801