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[Asymptomatic diclofenac-induced acute hepatitis]
A Dierkes-Globisch1, R Schäfer, H H Mohr
1Abteilung I, Innere Medizin, Bundeswehrzentralkrankenhaus Koblenz.
Deutsche Medizinische Wochenschrift (1946)
|August 1, 2000
Summary
Diclofenac, a common pain reliever, can cause toxic hepatitis, a serious liver condition. Regular liver function monitoring is crucial, even when the drug is considered safe.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Diclofenac is a widely used non-steroidal anti-inflammatory drug (NSAID).
- Post-lumbar disc herniation surgery, patients may experience recurrent pain managed with NSAIDs.
- NSAIDs carry potential risks, including adverse effects on liver function.
Observation:
- A 49-year-old male presented with jaundice and elevated liver enzymes (transaminases, cholestasis parameters) four months after lumbar disc surgery.
- Initial investigations ruled out viral, autoimmune, and metabolic causes of liver injury.
- Liver biopsy revealed toxic damage to the hepatic parenchyma.
Findings:
- The patient's presentation and laboratory findings were consistent with diclofenac-induced toxic hepatitis.
- Discontinuation of diclofenac led to normalization of liver function tests within nine weeks without specific treatment.
- This case highlights a severe, yet reversible, form of drug-induced liver injury.
Implications:
- Diclofenac, despite its common use and perceived safety, can induce severe hepatotoxicity.
- Healthcare providers should consider monitoring liver function in patients on long-term diclofenac therapy.
- Awareness of potential NSAID-induced liver injury is essential for patient safety and effective pain management.