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Transaminitis after treatment with clomiphene citrate: a case report.

BACKGROUND
Clomiphene citrate is widely used to induce ovulation in infertile women with anovulation. The manufacturer reports transaminitis as a possible side effect, but no case reports were found on a literature search.


CASE
A 30-year-old, Somali woman, gravida 3, para 1021, was referred for evaluation after trying unsuccessfully to conceive for 19 months. She was diagnosed with unexplained infertility and prescribed clomiphene citrate for ovulation induction. The patient took the medication in 2 consecutive cycles and each time developed intense right upper quadrant pain. During the second episode she presented to the emergency room with transaminitis. Acute and chronic viral hepatitis were ruled out, and she had not ingested any other medications; ultimately, no other etiology was discovered. The transaminitis resolved over 2 months and, in the absence of further treatment with clomiphene citrate, did not recur.


CONCLUSION
Transaminitis is a rare complication of treatment with clomiphene citrate. Liver function testing is warranted in patients with new-onset right upper quadrant pain after starting treatment with clomiphene citrate.