Cholestatic Hepatitis: An Unusual Presentation of Lisinopril-Mediated Hepatotoxicity

Singh, Gurpinder; Kachalia, Amit; Kaur, Jaspreet; Kachalia, Kinjal; Rizzo, Vincent

doi:10.14309/00000434-201410002-01234

Cited by 5 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ACE-I are frequently used in patients with hypertension, diabetic nephropathy and after myocardial infarction [ 1 ] . Severe side effects associated with ACE-I are uncommon.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…Cholestatic liver injury has been reported with several other ACE-I, including enalapril, ramipril and fosinopril [ 3 ] . A PubMed and Medline search yielded only six other reported cases of lisinopril-induced liver injury [ 1 , 4 – 8 ] . Of these, five showed hepatocellular damage and one showed cholestatic injury [ 1 ] .…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…A PubMed and Medline search yielded only six other reported cases of lisinopril-induced liver injury [ 1 , 4 – 8 ] . Of these, five showed hepatocellular damage and one showed cholestatic injury [ 1 ] . No patient had peripheral eosinophilia which is generally associated with hypersensitivity reactions [ 8 ] .…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…All, including the present case, developed lymphocytic or monocytic portal or peri-portal hepatitis [ 1 , 4 , 7 , 8 ] . Histological cholestasis was present in four cases [ 1 , 4 , 7 ] and three cases showed evidence of portal fibrosis [ 1 , 7 ] . Centrilobular necrosis was seen in one case only [ 4 ].…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…In three patients, the liver injury resolved. Three other patients (including the one reported here) died and one developed chronic liver disease [ 1 , 4 – 8 ] .…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

See 4 more Smart Citations

Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review

Al-Rifaie

Khan

Ali

et al. 2020

European Journal of Case Reports in Internal Medicine

View full text Add to dashboard Cite

Lisinopril is an angiotensin converting enzyme inhibitor (ACE-I) that has been on market for more than 25 years. ACE-I are usually well tolerated and rarely have serious or life-threatening side effects. We describe an unusual presentation of fulminant hepatic cholestasis probably secondary to lisinopril. To our knowledge, this is the second case report which shows lisinopril-induced liver injury though a cholestatic mechanism. The patient was a 59-year-old woman with type 2 diabetes, a high body mass index and hypertension, who presented with a 5-week history of jaundice and itching. She had been started on lisinopril for diabetic nephropathy 8 weeks before admission. Other causes for cholestasis had been excluded through non-invasive immunology and virology screening, an ultrasound of the liver, magnetic resonance cholangiopancreatography and a liver biopsy. The biopsy was consistent with drug-induced liver injury. Lisinopril was stopped 2 weeks before admission. The patient’s hospital stay was complicated by contrast nephropathy and influenza A which were both treated appropriately. Unfortunately, the liver cholestasis did not completely resolve following withdrawal of lisinopril and the patient died after 4 months. A literature search yielded only six other reported cases of lisinopril-induced liver injury. Five cases described hepatocellular damage and one showed cholestatic injury.

show abstract

“…ACE-I are frequently used in patients with hypertension, diabetic nephropathy and after myocardial infarction [ 1 ] . Severe side effects associated with ACE-I are uncommon.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…In three patients, the liver injury resolved. Three other patients (including the one reported here) died and one developed chronic liver disease [ 1 , 4 – 8 ] .…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

See 3 more Smart Citations