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Nimesulide-induced acute hepatitis.

W Sbeit1, N Krivoy, M Shiller

  • 1Department of Gastroenterology, Nahariya Hospital, B. Rappaport Faculty of Medicine, Technion, Israel. reshgs@naharia.health.gov.il

The Annals of Pharmacotherapy
|September 28, 2001
PubMed
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Nimesulide, a nonsteroidal anti-inflammatory drug (NSAID), can cause acute hepatitis. This case study confirms nimesulide-induced liver injury through biopsy and in vitro testing, emphasizing the need for monitoring.

Area of Science:

  • Hepatology
  • Clinical Pharmacology
  • Toxicology

Background:

  • Drug-induced liver injury (DILI) is a significant clinical concern.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, contributing to DILI cases.
  • Nimesulide, a selective cyclooxygenase-2 inhibitor NSAID, is prevalent in Europe and associated with potential liver toxicity.

Purpose of the Study:

  • To document a case of acute hepatitis attributed to nimesulide.
  • To confirm the etiological role of nimesulide using histological and in vitro methods.
  • To highlight the clinical implications of nimesulide-induced hepatotoxicity.

Main Methods:

  • A 54-year-old woman presented with acute hepatitis.
  • Liver biopsy confirmed hepatitis.

Related Experiment Videos

  • An in vitro lymphocyte toxicity assay was performed to link nimesulide to the liver injury.

    • Main Results:

    • The patient's acute hepatitis was histologically confirmed.
    • Liver function tests normalized within one month after discontinuing nimesulide.
    • In vitro assay demonstrated nimesulide's direct toxicity to lymphocytes.

    Conclusions:

    • Nimesulide can induce acute hepatitis, as evidenced by biopsy and in vitro findings.
    • While NSAID-induced liver damage is uncommon, widespread use makes them a notable cause.
    • Discontinuation of nimesulide is crucial for recovery, underscoring the importance of monitoring liver function during therapy.