Hydralazine-induced liver injury: a review and discussion

Abstract

Hydralazine is a commonly prescribed antihypertensive agent. Some of its labelled adverse reactions include lupus-like syndrome, tachycardia, headache and fever. Despite its well-known side effects, little is known about hydralazine’s hepatotoxic effects. We report the case of a 54-year-old female patient who was started on hydralazine for hypertension management but later presented with hydralazine-induced liver injury. Her initial presentation consisted of non-specific symptoms and a hepatocellular injury pattern. Liver biopsy revealed hepatic steatosis. Three weeks after discontinuation of hydralazine, the patient’s liver enzymes normalised, and her symptoms resolved. Few studies have examined the incidence and mechanism by which hydralazine induces a liver injury pattern. With this case, we review the literature, the pathogenesis involved and the eventual management of hydralazine-induced liver injury. We propose close monitoring of liver enzymes for patients on hydralazine throughout their treatment course.

Hypertensive and Hypotensive Emergencies in Interventional Radiology

“…6 The α-1 antagonist phentolamine can be used in certain circumstances such as pheochromocytoma crisis. 12 Parenteral administration of the βblocker esmolol has the advantage of onset within 1 minute 23 Nicardipine initial IV rate of 5 mg/hr, titrated up to 15 mg/hr, decreased to 3 mg/hr when target rate reached 24 2 min 2-4 h dizziness, avoid in patients with severe aortic stenosis and a short duration of less than 20 minutes. Hydralazine has the advantage of quick onset within a few minutes.…”