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Hepatotoxicity induced by a second-generation combined oral contraceptive: case report and review of the literature

Søs U Stannov, Annedorte Ries, Ulrich C Bang

4 Citations (Scopus)

Abstract

CASE: Second-generation combined oral contraceptives (COCs) are widely used and are believed to be safe for birth control and in the treatment of gynaecological diseases. No randomised controlled study has shown elevations in alanine transaminase (ALT) levels in relation to the use of a second-generation COC. We report a case of drug-induced liver injury (DILI) in a young, moderately obese woman, due to the use of a second-generation COC containing 30 µg ethinylestradiol and 150 µg levonorgestrel. COC use had been initiated 2 years prior to admission to our department. The diagnosis was based on elevated levels of ALT during COC use and was confirmed by re-challenge and a liver biopsy showing signs of former tissue damage after a 3 week break of COC treatment.

CONCLUSIONS: To our knowledge, this is the first case of biopsy-proven DILI due to COC use in which a re-challenge was performed.

Original languageEnglish
JournalThe European journal of contraception & reproductive health care : the official journal of the European Society of Contraception
Volume24
Issue number4
Pages (from-to)322-324
Number of pages3
ISSN1362-5187
DOIs
Publication statusPublished - Aug 2019

Keywords

  • Birth control
  • drug-induced liver injury (DILI)
  • ethinylestradiol
  • levonorgestrel
  • transaminase

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