FULMINANT HEPATIC-FAILURE ASSOCIATED WITH 2',3'-DIDEOXYINOSINE (DDI)

2',3'-Dideoxyinosine (ddI) is currently being evaluated in phase II-III clinical trials in the treatment of patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. In phase I trials of ddI, the major toxicities found were pancreatitis, peripheral neuropathy, hyperuricemia, and elevated hepatic aminotransferase levels. We report the case of a patient who developed pancreatitis and elevation of hepatic enzymes and who later died from fulminant hepatic failure while participating in a phase I trial of ddI. Physicians participating in clinical trials involving ddI should be aware that fulminant hepatic failure may be a potential side effect of this drug and that early interruption of ddI therapy may be warranted if serum aminotransferase levels become elevated.