ビカルタミドにより惹起された重症肝障害

Bicalutamide-induced Liver Toxicity in a Patient with Prostate Cancer

　79歳，男性。前立腺癌新鮮例，病期D1と診断し，total androgen blockageとして酢酸ゴセレリン（3.6mg／4週）とビカルタミド（80mg／日）による治療を開始した。投与前，投与1か月後の肝機能検査は正常であったが，投与43日目に上腹部痛を訴えて緊急受診した。検査上，肝機能障害が強かったので入院し，ビカルタミド投与を中止した。AST,ALTは投与開始後48日目に最高値（それぞれ403IU／l,512IU／l）に，総ビリルビンは47日目に最高値（5mg／dl）となり，そののち自然寛解した。

A 79-year-old man with stage D1 prostate cancer wastreated with oral bicalutamide (80mg/day) and goserelinacetate (3.6mg/4 weeks) in our clinic. He had emergencyadmission because of marked increase in serum aminotrans-ferase (ALT:512IU/l at maximum) and bilirubin (5.0mg/dl at maximum) 6 weeks after initiation of the treat-ment. His liver function was spontaneously normalized 2 months after discontinuation of bicalutamide. One of thesame group of antiandrogen, flutamide is well known tohave a side effect of liver toxicity, while bicalutamide isnot enough informed regarding its liver toxicity becauseof its recent use.