Flutamide-induced Hepatotoxicity: A Case Report

Abstract

Flutamide is a non-steroidal antiandrogen commonly used in the treatment of prostate cancer. Severe hepatotoxicity occurs in few patients, yet may be fatal. To date, none of the reported cases of flutamide hepatotoxicity has demonstrated thrombocytopenia and chronic liver disease. We report the case of a 55-year-old male with prostatic adenocarcinoma who developed liver failure after six months of flutamide therapy. The patient was referred with complaints of drowsiness, weakness, fatigue, and nausea in addition to jaundice, ascites, leg edema, splenomegaly, and bilateral pleural effusion. Laboratory findings included thrombocytopenia, hypoalbuminemia, and prolonged prothrombin time, with elevated aminotransferase and bilirubin. Abdominopelvic spiral computed tomography (CT) scan showed ascites and bilateral plural effusion. He discontinued flutamide and ursodeoxycholic acid (UDCA) was started. The patient completely recovered within four months. This was a rare case of flutamide-induced hepatotoxicity in a patient who referred with signs of advanced liver disease and thrombocytopenia. It appeared that UDCA was an effective therapy for flutamide hepatotoxicity.