{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:24:46Z","timestamp":1783358686287,"version":"3.54.6"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Goserelin is widely used for prostate cancer, but drug-induced liver injury (DILI) has been rarely reported. We present a patient who developed ALT\/AST elevations after each subcutaneous injection, followed by improvement after withdrawal and hepatoprotective therapy, with positive rechallenge upon re-exposure. By the EASL definition, the\n                    <jats:italic>R<\/jats:italic>\n                    -value was \u22486.0, indicating a hepatocellular pattern; Hy\u2019s law was not fulfilled. Causality assessed with the updated RUCAM (2016) yielded a total score of 11, corresponding to highly probable. Although the ALT peak did not exceed 5\u202f\u00d7\u202fULN, the consistent temporal association and positive rechallenge prompted discontinuation\/adjustment of goserelin with close biochemical follow-up, achieving a favorable outcome. This case underscores the need for vigilant monitoring\u2014particularly with higher doses or re-exposure\u2014and highlights the utility of\n                    <jats:italic>R<\/jats:italic>\n                    -value typing, Hy\u2019s law, and the updated RUCAM in guiding management. Liver biopsy was not performed, representing a limitation.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2025.1683370","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T06:40:29Z","timestamp":1764744029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Drug-induced liver injury highly probable due to goserelin: a case report evaluated with the updated RUCAM (2016)"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhun","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiqian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suping","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"254","DOI":"10.2165\/00003495-199141020-00008","article-title":"Goserelin: a review of its pharmacodynamic and pharmacokinetic properties, and clinical use in sex hormone-related conditions","volume":"41","author":"Chrisp","year":"1991","journal-title":"Drugs"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1056\/NEJMoa1103182","article-title":"Ulipristal acetate versus placebo for fibroid treatment before surgery","volume":"366","author":"Donnez","year":"2012","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"CD000547","DOI":"10.1002\/14651858.CD000547","article-title":"Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids","author":"Lethaby","year":"2001","journal-title":"Cochrane Database Syst Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e752","DOI":"10.1542\/peds.2008-1783","article-title":"Consensus statement on the use of gonadotropin-releasing hormone analogs in 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Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1517\/14656566.9.2.211","article-title":"Androgen deprivation therapy for prostate cancer","volume":"9","author":"Singer","year":"2008","journal-title":"Expert Opin Pharmacother"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1200\/JCO.2017.75.3335","article-title":"Quality of life during treatment with chemohormonal therapy: analysis of E3805 chemohormonal androgen ablation randomized trial in prostate cancer","volume":"36","author":"Morgans","year":"2018","journal-title":"J Clin Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.6004\/jnccn.2023.0050","article-title":"Prostate cancer, version 4.2023, NCCN clinical practice guidelines in oncology","volume":"21","author":"Schaeffer","year":"2023","journal-title":"J Natl Compr Cancer Netw"},{"key":"ref11","volume-title":"LiverTox: clinical and research information on drug-induced liver injury","year":"2012"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3390\/ijms17010014","article-title":"RUCAM in drug and herb induced liver injury: the update","volume":"17","author":"Danan","year":"2015","journal-title":"Int J Mol Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1053\/j.gastro.2014.05.027","article-title":"Drug-induced liver injury: morbidity, mortality, and Hy's law","volume":"147","author":"Regev","year":"2014","journal-title":"Gastroenterology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.20892\/j.issn.2095-3941.2024.0139","article-title":"Luteinizing hormone-releasing hormone receptor agonists and antagonists in prostate cancer: effects on long-term survival and combined therapy with next-generation hormonal agents","volume":"21","author":"Zhao","year":"2024","journal-title":"Cancer Biol Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.purol.2012.06.010","article-title":"Could gosereline acetate induce autoimmune-like hepatitis?","volume":"22","author":"Duburque","year":"2012","journal-title":"Prog Urol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1002\/hep.32689","article-title":"AASLD practice guidance on drug, herbal, and dietary supplement-induced liver injury","volume":"77","author":"Fontana","year":"2023","journal-title":"Hepatology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1588","DOI":"10.3390\/diagnostics15131588","article-title":"Drug-induced autoimmune hepatitis: robust causality assessment using two different validated and scoring diagnostic algorithms","volume":"15","author":"Teschke","year":"2025","journal-title":"Diagnostics"}],"container-title":["Frontiers in 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