Acute hepatic injury with atorvastatin: An unusual occurrence

Vishwakarma, Pinki; Nehra, Rajiv; Kumar, Alok

doi:10.4103/0253-7613.132197

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Using the Scopus, PubMed, and Google Scholar databases, we identified 531 manuscripts using the key words "statin" and "liver injury". Of the 15 manuscripts evaluated, there were nine case reports, [10][11][12][13][14][15][16][17][18] two of which discussed two patients. 11,17 The case reports are summarized in Table 1.…”

Section: Reported Casesmentioning

confidence: 99%

“…The other seven patients were followed by serial aminotransferase and imaging studies. [10][11][12][13][14][15][16][17][18] Eight of the patients had reported normal baseline aminotransferases prior to initiation of statin therapy, and nine had resolution of aminotransferase elevations following discontinuation of statin therapy, although three had also received steroid maintenance therapy. [10][11][12][13][14][15][16][17][18] None of the case reports took into consideration the possible presence of nonalcoholic fatty liver disease or elevated body mass index.…”

Section: Reported Casesmentioning

confidence: 99%

“…Changes in aminotransferases suggestive of hepatocellular pattern liver injury have been observed as early as a few hours after initial statin exposure to as late as 8 months after initiation. [10][11][12][13][14][15][16][17][18] While statin-induced hepatocellular liver injury is predominantly selflimiting and generally resolves within 6 months of offending agent cessation, some cases had autoimmune features and were treated with a brief steroid course to accelerate resolution. 10,11 A few reports described attempts at statin rechallenge, although with alternate formulations that did not induce liver injury.…”

Section: Treatment and Conclusionmentioning

confidence: 99%

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Statin-induced Liver Injury Patterns: A Clinical Review

Averbukh¹,

Turshudzhyan²,

Wu³

et al. 2022

J Clin Transl Hepatol

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Since their introduction in 1987, hydroxymethyl glutaryl coenzyme A reductase (HMG-CoA) inhibitors, more commonly known as statins, have become some of the most widely prescribed medications in the world. Though generally considered to be safe and well tolerated, statins have been associated with several side effects including mild liver dysfunction manifested by increases in aminotransferases. Rarely, statins have been noted to induce more serious hepatic injury, including liver injury with autoimmune features. Current literature supports statin induced liver injury presenting in either hepatocellular or cholestatic patterns, though with the former being the prevailing pattern of injury. Fortunately, severe liver injury is uncommon with statin use and is generally reversible without any intervention other than offending statin cessation. When evaluating cases of suspected statin-induced liver injury, a complete medical history, laboratory tests including a complete metabolic panel, autoimmune markers, and viral panel, as well as hepatic imaging, are crucial for a complete causality analysis with validated tools such as Roussel Uclaf Causality Assessment Method. The aim of this review is to review the current evidence for statin-induced liver injury and cholestasis.

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Section: Reported Casesmentioning

confidence: 99%

Section: Reported Casesmentioning

confidence: 99%

Section: Treatment and Conclusionmentioning

confidence: 99%

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Statin-induced Liver Injury Patterns: A Clinical Review

Averbukh¹,

Turshudzhyan²,

Wu³

et al. 2022

J Clin Transl Hepatol

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Atorvastatin

2014

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S Atorvastatin Acute hepatic injury: case reportA 63-year-old man developed acute hepatic injury while receiving atorvastatin.The man had been diagnosed with transient ischaemic attack (TIA) with hypertension and hyperlipidaemia. He started receiving atorvastatin 20mg once daily [route not stated]. One month later, he was found to have slightly increased levels of aminotransferase enzymes. Two months after the TIA, he presented with loss of appetite, fatigue, nausea, abdominal discomfort and yellowish discolouration of his eyes and skin. Laboratory investigations revealed elevated levels of AST, ALT, ALP and bilirubin. Atorvastatin-induced hepatotoxicity was suspected.Atorvastatin was withdrawn and replaced with rosuvastatin. Within 1 month, the man's aminotransferase levels returned to near normal, and his symptoms disappeared gradually.Author comment: "A Naranjo's score of 6 suggested "probable relationship" between atorvastatin and the acute hepatic injury. The idiosyncratic hepatic injury was defined as hepatocellular by Roussel Uclaf Causality Assessment method (RUCAM). The RUCAM score of this idiosyncratic event was 7, which indicates a probable link between hepatotoxicity and atorvastatin."

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Acute hepatic injury with atorvastatin: An unusual occurrence

Cited by 2 publications

References 6 publications

Statin-induced Liver Injury Patterns: A Clinical Review

Statin-induced Liver Injury Patterns: A Clinical Review

Atorvastatin

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