Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2020; 8(20): 4700-4707
Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4700
Remission of hepatotoxicity in chronic pulmonary aspergillosis patients after lowering trough concentration of voriconazole
Guo-Jie Teng, Xiang-Rong Bai, Lin Zhang, Hong-Jun Liu, Xiu-Hong Nie
Guo-Jie Teng, Lin Zhang, Xiu-Hong Nie, Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital Capital Medical University, Beijing 100053, China
Xiang-Rong Bai, Pharmacy Department, Xuanwu Hospital Capital Medical University, Beijing 100053, China
Hong-Jun Liu, Department of Evidence-based Medicine, Xuanwu Hospital Capital Medical University, Beijing, China, Beijing 100053, China
Author contributions: Teng GJ and Bai XR performed the diagnostic investigations and treatments; Teng GJ and Zhang L acquired the data and contributed to manuscript drafting; Teng GJ and Liu HJ were responsible for the statistics; Nie XH was responsible for revising the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Institutional review board statement: The study was approved by the Institutional Review Board of Xuanwu Hospital, Capital Medical University, Beijing, No. 2019-118.
Informed consent statement: All study participants provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this manuscript.
Data sharing statement: The original anonymous dataset used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiu-Hong Nie, PhD, Chief Doctor, Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. xiuhongnie@126.com
Received: May 17, 2020
Peer-review started: May 17, 2020
First decision: July 25, 2020
Revised: July 29, 2020
Accepted: September 1, 2020
Article in press: September 1, 2020
Published online: October 26, 2020
Processing time: 161 Days and 21.3 Hours
Core Tip

Core Tip: In this retrospective study, we evaluated 12 adult chronic pulmonary aspergillosis patients who developed hepatotoxicity during voriconazole treatment. The hepatotoxicity mainly manifested as a significant increase in the level of gamma-glutamyltransferase. In some patients, gamma-glutamyltransferase can reach up to 6-20 times the upper limit. Overall findings recommend that reducing the lower limit of the voriconazole trough concentration to 0.5 µg/mL can alleviate the hepatotoxicity of chronic pulmonary aspergillosis patients and maintain the clinical efficacy.