A case of drug-induced acute liver failure caused by corticosteroids

Autor: Akira Kajiwara, Yusuke Kawamura, Keiichi Kinowaki, Nozomu Muraishi, Soichi Iritani, Norio Akuta, Shunichiro Fujiyama, Hitomi Sezaki, Tetsuya Hosaka, Satoshi Saitoh, Masahiro Kobayashi, Yasuji Arase, Kenji Ikeda, Fumitaka Suzuki, Yoshiyuki Suzuki, Hiromitsu Kumada
Rok vydání: 2022
Předmět:
Zdroj: Clinical Journal of Gastroenterology. 15:946-952
ISSN: 1865-7265
1865-7257
DOI: 10.1007/s12328-022-01661-1
Popis: We report a 61-year-old man treated with betamethasone for sudden-onset deafness. Several days later, he had a temperature 38 °C. He sought care at another hospital and was admitted based on abnormal liver function tests (aspartate aminotransferase [AST], 866 IU/L [normal 31 IU/L] and alanine aminotransferase [ALT] 1524 IU/L [normal 31 IU/L]). Liver function improved daily and the patient was discharged from the hospital after 5 days. Two days after discharge, he had a recurrent fever and liver dysfunction. After admission to our hospital, liver function improved spontaneously. A liver biopsy was performed, but a diagnosis was not established; however, a tentative diagnosis of antinuclear antibody-negative autoimmune hepatitis was made and the patient was started on prednisolone (30 mg). Two days later, he developed a fever and persistent liver dysfunction, thus the prednisolone was discontinued. The next day, the AST and ALT increased significantly (18,000 and 12,000 U/L, respectively). Because the level of consciousness was altered, plasma exchange was started for acute liver failure. After discontinuing the prednisolone, the hospital course was uneventful. Drug-induced liver injury due to corticosteroids is rare. Herein, we report a patient with acute liver failure who survived with timely treatment.
Databáze: OpenAIRE
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