Article Text

Download PDFPDF
Drug-induced liver injury secondary to tamoxifen
  1. Deloshaan Subhaharan1,
  2. Grace Murphy2,
  3. Natalie Commins1 and
  4. Mary Azer2
  1. 1 Department of Hepatology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  2. 2 Department of Medical Oncology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  1. Correspondence to Dr Natalie Commins; natalie.commins{at}; Dr Deloshaan Subhaharan; deloshaan.subhaharan{at}


Tamoxifen is a non-steroidal selective oestrogen receptor modulator commonly used in the treatment of breast cancer. It is associated with the development of fatty liver and steatohepatitis however drug-induced liver injury is rare. We report a woman in her 50s who developed malaise with an acute moderate aminotransferase elevation without jaundice 6 months after starting tamoxifen. She was not commenced on any other recent drugs and extensive investigation including infective and autoimmune liver screen, cross-sectional imaging and FibroScan were unremarkable. Liver biopsy revealed moderate lobular hepatitis with hepatocyte drop-out. Tamoxifen was ceased and the liver enzymes showed resolution over the following 3 months and improvement of her symptoms.

  • Gastrointestinal system
  • Hepatitis other
  • Gastroenterology
  • Oncology
  • Unwanted effects / adverse reactions

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: DS, GM, NC and MA. The following authors gave final approval of the manuscript: DS, GM, NC and MA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.