Liver injury and rashes due to desloratadine citrate disodium tablets
Department of Pharmacy, the First Hospital of Jilin University, Changchun 130021, China; Department of Orthopedics, Wuxi Second Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Wuxi 214002, China
Abstract：A 32‑year‑old male patient received oral desloratadine citrate disodium tablets 8.8 mg once daily for allergic rhinitis. On the 6th day of medication, he developed sporadic red rashes on his abdomen, but he didn′t pay attention to it. On the 7th day of medication, the rashes increased and were with itching; urine color became dark brown; and he developed yellowish discoloration of hand skin and sclera. Laboratory tests showed alanine aminotransferase (ALT) 323 U/L, aspartate aminotransferase (AST) 186 U/L, gamma glutamyl transferase (γ‑GT) 309 U/L, total bilirubin (TBil) 63.9 μmol/L, and direct bilirubin (DBil) 33.6 μmol/L. He was diagnosed as having drug‑induced liver injury and allergic dermatitis, which were considered to be caused by desloratadine citrate disodium. Then the drug was stopped and the patient was given liver‑protective treatments and external application of mometasone furoate cream. On day 2 of desloratadine citrate disodium withdrawal, the color of his urine became lighter. On day 4 of drug withdrawal, the color of the rashes became lighter, the color of urine returned to normal, and there were no new rashes. On day 9 of drug withdrawal, the rashes disappeared basically. Liver function examination showed ALT 84 U/L, AST 29 U/L, γ‑GT 187 U/L, TBil 19.5 μmol/L, and DBil 8.0 μmol/L. Two weeks later, his ALT was 54 U/L， and other examination results were within the reference fange.
