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Acute cholestatic hepatitis associated with celecoxib
Antonio Grieco1, Luca Miele, Andrea Giorgi
1Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. agrieco@rm.unicatt.it
The Annals of Pharmacotherapy
|November 28, 2002
Summary
This case report details acute cholestatic hepatitis in a patient taking celecoxib, a selective cyclooxygenase-2 inhibitor. This adverse drug reaction highlights the importance of monitoring liver function even with drugs considered to have low hepatic toxicity.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Selective cyclooxygenase-2 (COX-2) inhibitors are widely used for pain and inflammation.
- While generally considered safe, potential adverse drug reactions, including hepatic toxicity, require ongoing evaluation.
- Understanding drug-induced liver injury is crucial for patient safety and accurate drug profiling.
Observation:
- A 41-year-old male developed jaundice after two doses of celecoxib for knee trauma.
- Laboratory tests revealed hyperbilirubinemia and cholestasis, with no biliary dilation on imaging.
- Liver histology confirmed cholestasis suggestive of drug-induced liver injury.
Findings:
- This is the fourth reported case of cholestatic hepatitis linked to celecoxib use.
- Histological findings strongly support celecoxib as the probable cause in this patient, who reported no other confounding exposures.
- The Naranjo probability scale confirmed celecoxib as a probable cause of acute cholestatic hepatitis.
Implications:
- This case contributes to the understanding of celecoxib's potential for hepatic adverse effects.
- Accurate drug safety profiles are essential for new medications entering clinical practice.
- Clinicians should remain vigilant for potential liver injury with COX-2 inhibitors, even when considered low risk.