Clarithromycin-Associated Acute Liver Failure Leading to Fatal, Massive Upper Gastrointestinal Hemorrhage from Profound Coagulopathy: Case Report and Systematic Literature Review

Table 1

Trend of liver function tests.

Laboratory value (normal laboratory range and units)	First hospitalization (16 days prior to 2^nd admission)	Day 1 second hospitalization (6 days after completing 7-day course of clarithromycin)	Day 2	Day 3	Day 4
Leukocyte count (3,500–10,100/μL)	15,000/µL	12,200/µL
Hemoglobin (13.5–17.0 g/dL)	13.6 g/dL	14.5 g/dL		5.5 g/dL
Platelets (150,000–400,000/μL)	209,000/μL	129,000/μL		35,000/μL
Aspartate aminotransferase (10–37 U/L)	39 U/L	499 U/L	1,119 U/L	9,470 U/L	10,820 U/L
Alanine aminotransferase (9–47 U/L)	72 U/L	539 U/L	1,110 U/L	6,420 U/L	7,210 U/L
Alkaline phosphatase (30–110 U/L)	55 U/L	127 U/L	171 U/L	358 U/L	202 U/L
Albumin (3.5–4.9 g/dL)	3.5 g/dL	3.4 g/dL	3.6 g/dL	2.9 g/dL	2.6 g/dL
Total bilirubin (0.3–1.2 mg/dL)	1.0 mg/dL	1.0 mg/dL	0.6 mg/dL	2.3 mg/dL	1.9 mg/dL
Direct bilirubin (0.0–0.4 mg/dL)	NA	NA	NA	1.8 mg/dL	1.3 mg/dL
INR (0.9–1.2)	NA	0.9		>9.0	>9.0

INR, international normalized ratio; NA, not applicable.