Li-Hsiang Liao

Publications (2)4.25 Total impact

• Article: Glycopeptide-induced neutropenia: cross-reactivity between vancomycin and teicoplanin.

  Shu-Hwa Hsiao, Chia-Ming Chang, Jui-Chen Tsai, Chia-Yin Lin, Li-Hsiang Liao, Wen-Liang Lin, Ta-Jen Wu
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  ABSTRACT: To report teicoplanin-related neutropenia that developed after an episode of neutropenia induced by vancomycin therapy. A 57-year-old female suffered from osteomyelitis of the left humerus, with a white blood cell (WBC) count of 2.8 x 10(3)/mm3 and absolute neutrophil count (ANC) of 0.28 x 10(3)/mm3, occurring after 24 days of vancomycin therapy. Vancomycin was changed to teicoplanin and the agranulocytosis resolved 4 days later. However, a new episode of neutropenia, with a WBC count of 2.8 x 10(3)/mm3 and ANC of 0.448 x 10(3)/mm3, occurred 11 days after teicoplanin initiation. Agranulocytosis resolved 4 days following withdrawal of teicoplanin. Because of the close time relationship between drug administration and the development of symptoms and signs, as well as between drug withdrawal and changes in WBC count and ANC, the episodes of neutropenia were suspected to be drug related. Teicoplanin-induced agranulocytosis that followed vancomycin-induced agranulocytosis suggests a possible cross-reactivity between the 2 drugs. Both reactions were categorized as probable according to the Naranjo probability scale. For all patients with vancomycin-induced neutropenia, possible cross-reactivity of teicoplanin should be monitored.
  Annals of Pharmacotherapy 05/2007; 41(5):891-4. · 2.13 Impact Factor
• Article: Hepatotoxicity associated with acarbose therapy.

  Shu-Hwa Hsiao, Li-Hsiang Liao, Pin-Nan Cheng, Ta-Jen Wu
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  ABSTRACT: To report a case of acarbose-induced hepatotoxicity and compare other reported cases from the literature. A 57-year-old woman with type 2 diabetes mellitus for about 10 years had been treated with insulin glargine 20 units/day since December 19, 2002. Acarbose 100 mg 3-times-daily add-on therapy for inadequate glycemic control was started on June 5, 2003. Six months later, the woman complained of gastrointestinal discomfort; the acarbose dose was decreased to 50 mg 3 times daily thereafter. Laboratory examination later revealed alanine aminotransferase (ALT) 640 U/L (upper reference value 55). To elucidate the possibilities of adverse reactions caused by concurrent use of nutritional supplements and medication, we discontinued propolis extract, Ginkgo biloba, placeta extract, and estrogen. Although no remarkable symptoms were noted thereafter, the abnormal ALT values persisted, and no definite viral or autoimmune etiologies were identified. Acarbose was discontinued in August 2004; aspartate aminotransferase and ALT values returned to normal in October 2004. In addition to ruling out other possible etiologic factors, we assessed the probability of acarbose-induced hepatotoxicity by observing the close time relationship between drug administration and the development of signs and symptoms, as well as the close time relationship between drug withdrawal and the normalization of abnormal liver function test values. An objective causality assessment revealed that an adverse drug reaction was probable as determined by both the Naranjo probability scale and the Roussel Uclaf Causality Assessment Method score. Although acarbose-induced hepatotoxicity appears to be uncommon, diabetic patients receiving long-term acarbose therapy should be closely monitored for this adverse effect.
  Annals of Pharmacotherapy 02/2006; 40(1):151-4. · 2.13 Impact Factor