Acute liver failure secondary to gemcitabine.

Gemcitabine is widely used in oncology practice. There are rare reports of gemcitabine causing hepatotoxicity with all affected patients dying from acute liver failure. We describe a patient with stage 4 lymphoma who presented with an acute deterioration in liver function tests and hepatic encephalopathy not directly attributed to his disease. He had been taking gemcitabine for 5 months before admission. His clinical and biochemical problems resolved after discontinuing the drug. This is the first case described of a severe hepatotoxic reaction associated with gemcitabine that was followed by a complete recovery.