Hepatotoxicity induced by clopidogrel

Beltrán-Robles, Manuel; Saavedra, Esther Márquez; Sánchez-Muñoz, Diego; Romero‐Gómez, Manuel

doi:10.1016/j.jhep.2003.11.013

Cited by 23 publications

(8 citation statements)

References 9 publications

(3 reference statements)

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“…Nine cases of clopidogrel‐induced acute hepatitis have so far been reported [3,4]. The age of these patients at the time of diagnosis ranged from 50 to 89 years.…”

Section: Discussionmentioning

confidence: 99%

Fatal liver injury associated with clopidogrel

Kastalli¹,

Aidli²,

Zaiem³

et al. 2010

Fundamemntal Clinical Pharma

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Clopidogrel, an adenosine diphosphate receptor blocker, is widely used as an adjunctive antiplatelet therapy in acute coronary syndrome and percutaneous coronary stenting. It appears to be a safe drug with few occurrences of liver side-effects that usually resolved after drug withdrawal. We report a serious liver injury with fatal outcome in a 63-year-old man developed 19 days after starting clopidogrel for percutaneous coronary stenting.

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“…Nine cases of clopidogrel‐induced acute hepatitis have so far been reported [3,4]. The age of these patients at the time of diagnosis ranged from 50 to 89 years.…”

Section: Discussionmentioning

confidence: 99%

Fatal liver injury associated with clopidogrel

Kastalli¹,

Aidli²,

Zaiem³

et al. 2010

Fundamemntal Clinical Pharma

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“…2 As of now, 14 cases of clopidogrel-related hepatitis have been described in the literature (Table 2). 2,[5][6][7][8][9][10][11][12][13][14][15][16] The degree of liver injury ranges from moderate transaminase elevation to serious acute hepatitis as observed in our patient. Ten of the patients developed a mixed hepatocellular and cholestatic injury, 3 a predominantly hepatocellular damage, and 1 patient developed systemic inflammatory response syndrome including fever, rash, tachycardia, and leucopenia.…”

Section: Discussionmentioning

confidence: 98%

Acute Hepatitis Associated With Clopidogrel

Pisapia

Abdeddaim

Mariano

et al. 2015

American Journal of Therapeutics

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Drug-induced hepatotoxicity is a common cause of acute hepatitis, and the recognition of the responsible drug may be difficult. We describe a case of clopidogrel-related acute hepatitis. The diagnosis is strongly suggested by an accurate medical history and liver biopsy. Reports about cases of hepatotoxicity due to clopidogrel are increasing in the last few years, after the increased use of this drug. In conclusion, we believe that physicians should carefully consider the risk of drug-induced hepatic injury when clopidogrel is prescribed.

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“…As of this writing, 12 cases had been published that describe one of these rare complicationsclopidogrel-induced hepatotoxicity ( Table 1) [17][18][19][20][21][22][23][24][25][26][27][28] ; our case represents the 13th published report. All patients (six men, seven women) were aged 50-89 years at the time of diagnosis (mean ± SD age 70.4 ± 12.3 yrs) and revealed biochemical evidence of hepatic injury 3 days-6 months after commencement of clopidogrel for coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Clopidogrel‐Induced Hepatocellular Injury and Cholestatic Jaundice in an Elderly Patient: Case Report and Review of the Literature

2009

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In patients undergoing percutaneous coronary intervention and in those with acute coronary syndromes, clopidogrel plus aspirin is the first-line antiplatelet therapy for reducing cardiovascular events. Although clopidogrel is generally well tolerated, with rash, indigestion, vomiting, diarrhea, and bleeding being the most common adverse effects, rare but serious complications may occur. We describe a 78-year-old woman who underwent percutaneous coronary intervention with drug-eluting stents; clopidogrel and aspirin were started as antiplatelet therapy. Three weeks later, the patient developed mixed hepatocellular and cholestatic liver injury. Clopidogrel was discontinued, and her liver profile results began to improve. Her diagnostic work-up included screening for hepatitis, infectious mononucleosis, and rheumatologic diseases, as well as ultrasonography, magnetic resonance imaging, and endoscopic retrograde cholangiopancreaticography; all results were normal. On day 5 of hospitalization, because of the patient's risk for thrombosis secondary to the drug-eluting stents, clopidogrel was reintroduced; her liver enzyme levels increased. In the absence of any biliary obstruction or other obvious causes of hepatic injury, drug-induced hepatocellular injury and cholestatic jaundice were suspected, and clopidogrel was again discontinued. The patient's liver function tests gradually improved 3 days later and showed marked improvement at her 2-week follow-up visit after discharge. Use of the Maria and Victorino scale for diagnosis of drug-induced hepatotoxicity indicated a probable (score of 14) relationship between clopidogrel and mixed hepatocellular injury and cholestatic jaundice in this patient. Although routine liver function testing is not recommended in patients who receive clopidogrel, having a high index of clinical suspicion, drug rechallenge, and excluding other obvious causes are required to establish the diagnosis of a rare drug complication such as clopidogrel-induced hepatic injury.

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Hepatotoxicity induced by clopidogrel

Cited by 23 publications

References 9 publications

Fatal liver injury associated with clopidogrel

Fatal liver injury associated with clopidogrel

Acute Hepatitis Associated With Clopidogrel

Clopidogrel‐Induced Hepatocellular Injury and Cholestatic Jaundice in an Elderly Patient: Case Report and Review of the Literature

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