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Related Experiment Videos

[Cimetidine hepatitis].

R Zaidenstein1, N Cohen, A Golik

  • 1Medical Dept. A, Assaf Harofeh Medical Center, Zerifin.

Harefuah
|December 15, 1992
PubMed
Summary
This summary is machine-generated.

Cimetidine can cause severe acute hepatitis in some patients, though rare. This case highlights the importance of considering drug-induced liver injury when evaluating hepatitis, especially with cimetidine use.

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Area of Science:

  • Hepatology
  • Pharmacology
  • Clinical Medicine

Background:

  • Rheumatoid arthritis is a chronic autoimmune disease.
  • Duodenal ulcers are common gastrointestinal conditions.
  • Cimetidine is a histamine H2 receptor antagonist used for acid reduction.

Observation:

  • A 41-year-old male patient with rheumatoid arthritis developed severe acute hepatitis.
  • The hepatitis onset occurred 3 days after initiating cimetidine therapy for a duodenal ulcer.
  • Alternative causes of hepatitis were excluded.

Findings:

  • The patient recovered fully after cimetidine was discontinued, suggesting a drug-induced etiology.
  • While mild hepatic enzyme elevations are reported in 3.6% of cimetidine users, severe acute hepatitis is rare.

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  • Only 12 cases of severe acute hepatitis linked to cimetidine have been documented in English literature, often due to idiosyncrasy.

    • Implications:

    • This case underscores the potential for cimetidine to cause severe, idiosyncratic drug-induced liver injury.
    • Clinicians should maintain a high index of suspicion for cimetidine-induced hepatitis in patients presenting with acute liver injury.
    • Awareness of this rare but serious adverse effect is crucial for patient safety and appropriate management.