L-carnitine and Vitamin B Complex for PEG-L-asparaginase-Induced Hepatotoxicity. Issue 8 (28th August 2019)

• Record Type: Journal Article
• Authors: Arora, Sumant; Klair, Jagpal; Bellizzi, Andrew M.; Tanaka, Tomohiro
• Is Part Of: ACG Case Reports Journal. Volume 6:Issue 8(2019)
• Page Start: e00194
• Publication Date: 2019-08-28
• DOI: 10.14309/crj.0000000000000194
• Languages: English
• ISSNs: 2326-3253

Abstract

ABSTRACT: Asparaginase is a part of combination chemotherapy for acute lymphoblastic leukemia. We present a 58-year-old woman with refractory acute lymphoblastic leukemia who developed asparaginase-induced hepatotoxicity after receiving intravenous PEG-L-asparaginase-based chemotherapy. The patient presented with hyperbilirubinemia and transaminitis. The patient was diagnosed with drug-induced liver injury due to PEG-L-asparaginase after a thorough evaluation for all other causes and received treatment with L-carnitine and vitamin B complex with normalization of liver numbers. Hepatic dysfunction was attributed to depletion of L-asparagine and glutamine, which impairs mitochondrial β-oxidation and induces steatosis. We reiterate the role of L-carnitine and vitamin B complex for the treatment of asparaginase-induced hepatotoxicity.