scholarly journals Aseptic meningitis, hepatitis and cholestasis induced by trimethoprim/sulfamethoxazole: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. A. A. van Asperdt ◽  
R. A. De Moor
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Liver Injury ◽  
Aseptic Meningitis ◽  
Cholestatic Hepatitis ◽  
Diagnostic Challenge ◽  
Drug Induced ◽  
Case Presentation ◽  
Drug Induced Liver Injury ◽  
Inflammatory Drugs

Abstract Background Drug-induced aseptic meningitis is a rare, but challenging diagnosis, most commonly reported with nonsteoroidal anti-inflammatory drugs (NSAIDs) and antibiotics. Trimethoprim/sulfamethoxazole (TMP/SMX) is a sulfonamide that is widely used in clinical practice for the treatment and prophylaxis of various infections. The most common side effects associated with TMP/SMX are generally mild and self-limited, but serious side effects have been reported, including liver injury and aseptic meningitis. Case presentation We report a 2,5 year old Dutch girl with both drug-induced aseptic meningitis and drug-induced liver injury while using TMP/SMX prophylaxis. Ursodeoxycholic acid was started because of cholestatic injury. After cessation of TMP/SMX, full convalescence was reached within weeks. Conclusions This is the first report of a young patient with both aseptic meningitis and drug-induced liver injury caused by TMP/SMX. Drug-induced aseptic meningitis and cholestatic hepatitis constitute a considerable diagnostic challenge to clinicians. In addition to a thorough evaluation for infectious causes, clinicians should be aware of drug-induced aseptic meningitis and cholestatic hepatitis.

A case of statin-induced liver injury with positive rechallenge with a second statin. Is there a class effect?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Giovanna Onfiani ◽  
Fabio Nascimbeni ◽  
Francesca Carubbi
Keyword(s):  
Liver Injury ◽  
Clinical Symptoms ◽  
High Risk Population ◽  
Drug Induced ◽  
Case Presentation ◽  
Drug Induced Liver Injury ◽  
Aged Woman ◽  
Cardiovascular Morbidity And Mortality ◽  
Middle Aged Woman

Abstract Objectives Statins have proved to reduce cardiovascular morbidity and mortality in high-risk population and are generally well tolerated, although adverse events can occur. Up to 3% of patients develop aminotransferases elevation, which usually normalizes with continued treatment and hardly is associated with clinical symptoms. Serious statin-related liver injury is exceedingly rare. Furthermore, literature regarding rechallenge with a second statin is extremely poor. Some authors caution that re-exposure to these drugs is associated with a more serious liver injury but safe switching to a second statin after drug-induced liver injury (DILI) is also reported. Case presentation We describe a case of a middle-aged woman who developed hepatocellular liver injury after simvastatin dose escalation; a rechallenge with low dose rosuvastatin caused rapid recurrence of DILI. Conclusions In our opinion, clinicians should be very cautious upon rechallenge and closely follow-up patients who experienced statin-induced liver injury when trying re-exposure to another statin.

scholarly journals Drug-Induced Autoimmune Hepatitis following Treatment with Zoledronic Acid

2017 ◽  
Vol 11 (2) ◽  
pp. 440-445 ◽  
Author(s):  
Jenny Sarah Schneider ◽  
Matteo Montani ◽  
Felix Stickel
Keyword(s):  
Liver Disease ◽  
Zoledronic Acid ◽  
Side Effects ◽  
Liver Injury ◽  
Drug Reactions ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
First Case ◽  
Alternative Drugs

Adverse drug reactions are among the most frequent side effects of synthetic and complementary alternative drugs and represent the premier causes of license revocations and acute liver failure. Drug-induced liver injury can resemble literally any other genuine liver disease and usually responds well to drug dechallenge. However, in some cases autoimmune-like hepatitis can evolve, requiring short- and sometimes long-term immunosuppression. Here, we present the hitherto first case of autoimmune-like hepatitis following treatment with zoledronic acid.

scholarly journals A case report of a drug‐induced liver injury (DILI) caused by multiple antidepressants with causality established by the updated Roussel Uclaf causality assessment method (RUCAM) and in vitro testing

2020 ◽  
Vol 8 (12) ◽  
pp. 3105-3109
Author(s):  
Miguel González‐Muñoz ◽  
Jaime Monserrat Villatoro ◽  
Eva Marín‐Serrano ◽  
Stefan Stewart ◽  
Belén Bardón Rivera ◽  
...  
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Causality Assessment ◽  
Assessment Method ◽  
In Vitro Testing ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Sa1558 Risk of Non-Steroidal Anti-Inflammatory Drugs-Related Serious Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 150 (4) ◽  
pp. S1066
Author(s):  
Sakkarin Chirapongsathorn ◽  
Chayakrit Krittanawong ◽  
Ann M. Farrell ◽  
Mohammad H. Murad ◽  
Patrick Kamath
Keyword(s):  
Systematic Review ◽  
Liver Injury ◽  
Meta Analysis ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

A Case Report of Rifampin Alone Drug Induced Liver Injury (DILI)

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1271
Author(s):  
Ashina D. Singh ◽  
Scott A. Manski ◽  
Nathalie H. Urrunaga
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Drug Induced ◽  
Drug Induced Liver Injury

scholarly journals Drug Liver Injury Induced by Olmesartan Mediated by Autoimmune-Like Mechanism: A Case Report

2020 ◽  
Author(s):  
Manuel de la Torre-Aláez ◽  
Mercedes Iñarrairaegui
Keyword(s):  
Case Report ◽  
Liver Injury ◽  
Drug Exposure ◽  
Interesting Case ◽  
Suspected Drug ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Difficult Diagnosis ◽  
Histological Confirmation ◽  
The Relationship

Autoimmune hepatitis (AIH) was the first liver disease for which an effective therapeutic intervention was carried out, using prednisolone; its usefulness was demonstrated in several clinical trials. Nevertheless, AIH still remains a difficult diagnosis in some cases, because it is necessary to dismiss other possible diagnoses, and perhaps due to it being a heterogeneous disease. The relationship between drug-induced liver injury (DILI) and AIH is complex and not fully understood. There are three possible scenarios: (1) DILI with a strong immunoallergic component mimicking AIH; (2) AIH mimicking a DILI due to drug exposure and (3) AIH triggered by exposure to an offending drug (drug-induced AIH). Drug-induced AIH is well described and documented for some drugs such as nitrofurantoin and minocycline. Histologically distinguishing DILI from AIH remains a challenge. We present an interesting case report which met serologic criteria and histological confirmation to establish AIH, but discontinuation of a suspected drug resolved hypertransaminasaemia.

scholarly journals Tuberculosis Arthritis Genu Sinistra with Drug-Induced Liver Injury, COVID 19 Confirmed

2022 ◽  
Vol 6 (3) ◽  
pp. 1460-1464
Author(s):  
Yonis Ismed ◽  
Radiyati Umi Partan ◽  
Ismail Bastomi
Keyword(s):  
Liver Injury ◽  
Extrapulmonary Tuberculosis ◽  
Left Knee ◽  
Drug Induced ◽  
Case Presentation ◽  
Drug Induced Liver Injury ◽  
Main Complaint ◽  
Laboratory Examinations ◽  
Hepatocyte Death ◽  
Significant Health

Background. Tuberculosis is still a significant health problem, especially in developing countries. Although pulmonary tuberculosis is the most common form of the disease, extrapulmonary tuberculosis also contributes significantly to morbidity and mortality. 10-15% of extrapulmonary cases are due to tuberculous arthritis. The following is a case report of a 36-year-old woman with a diagnosis of genu Sinistra tuberculosis arthritis and drug-induced hepatotoxic injury due to OAT. Case presentation. A woman, 36 years old, Muslim, addresses Banyuasin. The patient is a housewife, treated at Dr. Moh Hoesin General Hospital since October 11, 2021. The main complaint in the form of pain in the left knee has been getting worse since 1 week before being admitted to the hospital. 4 months before admission the hospital, the patient complained of left knee pain, the pain felt like being stabbed, coming and going, especially when walking. In this patient, there was a complaint of nausea that was felt in the pit of the stomach. The results of laboratory examinations showed an increase in the transaminase enzyme and hyperuricemia, so it was suspected that the patient had DILI due to OAT drugs. Hepatocyte death in DILI can occur through two processes, namely processes mediated by apoptosis or necrosis. In apoptosis, cell shrinkage and fragmentation occur into small pieces with the cell membrane intact. These fragments are cleared by phagocytosis and generally do not stimulate the host immune response. Conclusion. A patient diagnosed with arthritis tuberculosis genu Sinistra with Drug-Induced Liver Injury and Confirmed COVID 19.

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