Abnormal Liver Function Test and Statins

Introduction: Statins or 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors are one of the foremost commonly endorsed medications in cardiac patients. A bit like any other lesson of drugs, they have the potential to cause liver harm over time indeed with reasonable utilize. This drug induced liver harm (DILI) can be either coordinate (hepatocellular) or peculiar. As with multiple other hepatic pathologies, DILI may be asymptomatic or clinically quiet. Subsequently, it is judicious to carry out liver work tests (LFTs) from time to time. LFTs are an inexpensive, noninvasive, and fast first-line examination to monitor liver status. Be that as it may, the design of liver damage with statin utilize isn't particular and a relationship over time may not be clear. Objectives: To assess the derangements in Liver function test with regard to statin utilization and decide if there is any correlation exists. Method: Retrospective Observational study conducted in Punjab Institute of Cardiology, Lahore, from 31st July 2020 to 30 June 2021. Data Collection Procedure: This study is conducted at Punjab Institute of cardiology, Lahore, a total of 100 patients admitted from 1st July 2020 to 30 June 2021 with ischemic heart diseases were considered for inclusion as this was retrospective observational cohort study. The patients already taken statin were included in this study. LFTs were noted before the start of statin in their records then during the use of statin at 3rd and 6th month with great care. The collected data was analyzed by using SPSS version 23. Results: A total number of 100 patients were included in this study after inclusion exclusion criteria. The ratio male to female is 3:2.Patients using two types of statin i.e. Atorvastatin 20mg and Rosuvastatin 10mg were included. LFTs elevation was seen in the study. Conclusion: The use of statins clinically proved insignificant elevation of LFTs and hence it is safe to prescribe. Keywords: (HMG-CoA) reductase, Liver finction tests, Statin, LFTs

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Warfarin‐induced Stevens–Johnson syndrome with severe liver injury

Journal of International Medical Research ◽

10.1177/03000605211033196 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110331

Author(s):

Hao Xiong ◽

Tao Liu ◽

Jieping Xiao ◽

Jianji Wan ◽

Jie Yang ◽

...

Keyword(s):

Liver Injury ◽

Liver Function ◽

Liver Function Test ◽

Elispot Assay ◽

Stevens Johnson Syndrome ◽

Multiple Drug ◽

Abnormal Liver Function Test ◽

Drug Induced ◽

Johnson Syndrome ◽

Function Test

Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a life-threatening mucocutaneous disease that is predominantly drug-induced. Warfarin is the most commonly used drug for long-term anti-coagulant therapy; however, warfarin-induced SJS/TEN is seldom reported. In this study, we presented the case of a 61-year-old man who developed SJS after receiving multiple-drug therapy following aortic valve replacement surgery. The patient was diagnosed with drug-induced liver injury (DILI) based on significantly abnormal liver function test results. Warfarin was identified as the culprit drug using the algorithm of drug causality for epidermal necrolysis (ALDEN) score, enzyme-linked immunospot (ELISPOT) assay, and Roussel Uclaf Causality Assessment Method (RUCAM). After warfarin discontinuation and corticosteroid therapy, the lesions and liver function test findings improved. Human leukocyte antigen typing was conducted to detect the risk allele. To our knowledge, this is the first reported case of warfarin-induced SJS/TEN with DILI. This case suggests that commonly used and safe pharmaceutical agents such as warfarin can potentially cause serious adverse events, including SJS/TEN and DILI. The application of ALDEN, the ELISPOT assay, and RUCAM could be useful in identifying culprit drugs.

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