Antiviral (Hepatitis C Virus) Drug-Drug Interaction Leading to Dramatic Underestimation of Liver Function With 99mTc-Mebrofenin Hepatobiliary Scintigraphy

Clin Nucl Med. 2020 Feb;45(2):133-135. doi: 10.1097/RLU.0000000000002861.

Abstract

There is a growing interest in assessment of future remnant liver function with Tc-mebrofenin hepatobiliary scintigraphy before major hepatectomy to estimate the risk of posthepatectomy liver failure. We illustrate the case of a 42-year-old woman with liver metastasis from colorectal cancer who performed hepatobiliary scintigraphy. Tc-mebrofenin clearance rate of the total liver was considerably low. The patient recently started a treatment for active hepatitis C with a combination of 2 new direct-acting antiviral agents (grazoprevir, elbasvir). Apart from hypoalbuminemia or hyperbilirubinemia, physicians must be aware that drug interactions can interfere with Tc-mebrofenin liver uptake, thereby resulting in a dramatic underestimation of liver function.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amides
  • Aniline Compounds
  • Antiviral Agents / adverse effects*
  • Benzofurans / adverse effects*
  • Carbamates
  • Cyclopropanes
  • Drug Interactions
  • Female
  • Glycine
  • Hepacivirus
  • Humans
  • Imidazoles / adverse effects*
  • Imino Acids
  • Liver Failure / diagnostic imaging*
  • Liver Failure / etiology
  • Organotechnetium Compounds
  • Quinoxalines / adverse effects*
  • Radionuclide Imaging*
  • Radiopharmaceuticals
  • Sulfonamides

Substances

  • Amides
  • Aniline Compounds
  • Antiviral Agents
  • Benzofurans
  • Carbamates
  • Cyclopropanes
  • Imidazoles
  • Imino Acids
  • Organotechnetium Compounds
  • Quinoxalines
  • Radiopharmaceuticals
  • Sulfonamides
  • grazoprevir
  • elbasvir
  • technetium Tc 99m mebrofenin
  • Glycine