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Diclofenac-associated hepatitis.

A Bhogaraju1, S Nazeer, Y Al-Baghdadi

  • 1Department of Internal Medicine, University of Illinois College of Medicine at Urbana-Champaign, Urbana, USA.

Southern Medical Journal
|July 22, 1999
PubMed
Summary

Diclofenac, a nonsteroidal anti-inflammatory drug, can cause severe hepatitis. Promptly discontinuing diclofenac led to full liver function recovery in a patient with osteoarthritis.

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Area of Science:

  • Hepatology
  • Clinical Pharmacology

Background:

  • Osteoarthritis management often involves nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Diclofenac is a commonly prescribed NSAID for pain relief.

Observation:

  • A patient developed severe hepatitis 5 weeks after initiating diclofenac for osteoarthritis.
  • Upper gastrointestinal symptoms suggestive of gastritis preceded the hepatitis onset.
  • Discontinuation of diclofenac resulted in complete liver function restoration.

Findings:

  • Diclofenac can induce severe, idiosyncratic drug-induced liver injury (DILI).
  • Early recognition and cessation of the offending agent are crucial for recovery.
  • Gastrointestinal complaints may precede or coincide with NSAID-induced hepatotoxicity.

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Implications:

  • Healthcare providers should maintain a high index of suspicion for diclofenac-induced liver injury.
  • Increased awareness of this rare but serious adverse effect is necessary.
  • Further research into the incidence and management of diclofenac hepatotoxicity is warranted.