Alfuzosin-induced hepatotoxicity.

Area of Science:

• Hepatology
• Pharmacology
• Toxicology

Background:

• Drug-induced hepatic injury (DIHI) is a significant clinical concern due to the liver's central role in drug metabolism.
• The precise mechanisms underlying DIHI are often complex and not fully elucidated for many medications.

Observation:

• A case of severe acute mixed hepatitis, encompassing both cholestatic and hepatocellular patterns, is presented.
• This specific liver injury was potentially linked to the use of alfuzosin, an alpha-1 adrenergic blocker.
• The patient's presentation mimicked other causes of liver disease, necessitating thorough exclusion of viral, autoimmune, and obstructive biliary etiologies.

Findings:

• Diagnostic workup excluded viral hepatitis, autoimmune liver disease, and biliary tree obstruction as causes of the observed liver injury.
• Cessation of alfuzosin administration led to a complete normalization of liver function test results.
• This case represents a previously unreported instance of severe acute mixed hepatitis potentially induced by alfuzosin.

Implications:

• This report highlights the potential hepatotoxicity of alfuzosin, adding to the spectrum of known drug-induced liver injuries.
• Clinicians should consider alfuzosin as a potential cause of acute hepatitis in patients presenting with compatible liver enzyme patterns.
• Further investigation into the specific mechanisms of alfuzosin-induced liver injury may be warranted to improve patient safety and risk management.