Late-onset cholestatic hepatitis induced by olanzapine in a patient with schizophrenia.

摘要

Olanzapine is an atypical antipsychotic agent used in the treatment of schizophrenia, bipolar, and depressive disorder. In addition to its particular spectrum of adverse reactions (Kantrowitz and Citrome, 2008), rare cases of olanzapine-associated symptomatic hepatitis have been recorded (Jadallah et al., 2003; Ozcanli et al., 2006; Raz et al., 2001; Tchernichovsky and Sirota, 2004) (Table 1). Until now, the exact mechanism of such rare adverse reaction remained unknown.In three of these four cases, the appearance of hepatitis occurred within two months of treatment, and the other case, reported by Ozcanli et al. did not occur until three years of olanzapine treatment. Additionally, only the case reported by Tchernichovsk and Sirota was confirmed by olanzapine re-administration, an important determinant of causality. In this report, we describe a case of olanzapine monotherapy-induced cholestatic hepatitis in the third year of treatment, confirmed with a positive rechallenge test.