Related Experiment Videos
Fatal cholestatic jaundice associated with amitriptyline
H S Randeva1, V Bangar, S Sailesh
1Department of Medicine, University of Warwick, Coventry, UK.
International Journal of Clinical Practice
|November 25, 2000
Summary
Amitriptyline, an antidepressant, can cause severe liver injury. This case highlights drug-induced cholestasis leading to fatal liver and kidney failure in an elderly patient.
Area of Science:
- Hepatology
- Clinical Pharmacology
Background:
- Amitriptyline is a widely prescribed tricyclic antidepressant.
- Drug-induced liver injury (DILI) is a significant clinical concern.
Observation:
- A 75-year-old woman developed anorexia and abdominal pain after four months of amitriptyline use.
- She presented with jaundice and progressive hyperbilirubinemia without biliary obstruction.
Findings:
- The patient experienced deteriorating liver function, leading to hepatorenal syndrome and a fatal gastrointestinal bleed.
- Autopsy revealed pure cholestasis, strongly implicating amitriptyline as the cause.
Implications:
- This case underscores the potential for amitriptyline to cause severe cholestatic liver injury.
- Clinicians should consider DILI in patients with unexplained liver dysfunction, especially those on amitriptyline.