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Acute liver failure following intravenous methamphetamine
Yoshito Kamijo1, Kazui Soma, Manami Nishida
1Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Sagamihara Kanagawa, Japan.
Veterinary and Human Toxicology
|July 26, 2002
Summary
Illicit methamphetamine use can cause severe liver damage, even without viral infections. This case highlights acute liver injury following methamphetamine injection, emphasizing the need for awareness among healthcare providers.
Area of Science:
- Toxicology
- Hepatology
- Emergency Medicine
Background:
- Methamphetamine (MAP) is a potent central nervous system stimulant with a high potential for abuse.
- While known for its neurotoxic effects, MAP's potential to cause acute liver injury (ALI) is less understood.
- This case examines ALI in the context of recreational MAP use.
Observation:
- A 41-year-old male presented with psychosis, hyperthermia, rhabdomyolysis, and liver dysfunction 6 hours post-intravenous MAP injection.
- Initial serum MAP and amphetamine levels were 0.30 µg/mL and 0.04 µg/mL.
- Liver enzymes, including total serum bilirubin and alanine aminotransferase, peaked on day 3, indicating significant hepatocellular damage.
Findings:
- Histological examination of a liver biopsy revealed centrilobular confluent necrosis and ballooning degeneration.
- No evidence of infectious hepatitis or other drug intake was found.
- The patient recovered with supportive care, suggesting MAP as the direct cause of liver injury.
Implications:
- Acute liver damage is a potential complication of illicit methamphetamine use.
- Clinicians should consider MAP toxicity in patients presenting with unexplained liver dysfunction, especially those with risk factors.
- Further research is needed to elucidate the mechanisms of MAP-induced hepatotoxicity.