Posted by yxibow on May 10, 2006, at 22:54:03
In reply to Re: Liver Enzyme Article (Wash. Post), posted by saturn on May 10, 2006, at 21:23:07
> >> Shirley Roberts, an African American from Orange Park, Fla., desperately wishes she'd known she was an intermediate metabolizer for both the 2D6 and the 2C19 genes. When the former parole officer suffered from severe depression in 2002, doctors first prescribed Zoloft (metabolized by the 2C19 and 2D6 enzymes, among others). The entry-level dose was okay, but when it was raised, she experienced gastrointestinal problems, hair loss, night sweats, fever and heart palpitations. She switched to Paxil (metabolized by 2D6) and then Wellbutrin (metabolized by 2D6 and three other enzymes), but bad side effects continued.
> >
> > In April 2004, after nearly two years of antidepressant treatment, Roberts's doctors took her off the drugs when her blood tests showed elevated liver enzymes. Doctors first assumed she'd contracted a viral form of hepatitis, she recalls, but tests came back negative. The diagnosis: drug-induced autoimmune hepatitis, with permanent liver damage. Testing by Genelex, a DNA lab in Seattle -- at a cost of $800, paid by Roberts's insurer -- identified her enzyme problem. Roberts says she's been told her life expectancy is eight to 10 years.
>
> Could being an intermediate (or even poor for that matter) metabolizer have caused her drug-induced autoimmune hepatitis? Toxicity--for sure, but the hepatitis-I'm skeptical about that. Is this likely?
>
> I've had such horrible reactions to some meds I just may test the 2D6 if I ever go on them again. $250 is hefty, but it's a lot cheaper than an ER visit for sure.
Yes, in an extreme rare case, and the woman of African American race which puts her functional alleles for those P450 enzymes at a lower position than other sections of the population in various studies. I would say the outcome is obiously unfortunate and terribly rare, rather than just some liver damage which is easily detectable by jaundice in early stage, than a complex disorder, but possible.
The Amplichip is an exciting brave new world which will hopefully bring more uses of genome and stem cell usage to bring ideas to the market.
poster:yxibow
thread:642166
URL: http://www.dr-bob.org/babble/20060510/msgs/642426.html