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Severe hepatic necrosis associated with methyldopa.

I A Cameron, J L Achord, H Bartee

Canadian Family Physician Medecin De Famille Canadien

|February 4, 2011

Summary

Family physicians must monitor patients on methyldopa for potential liver toxicity. Overlooking this risk, as seen in a case report, can lead to severe liver failure and hepatic coma.

Area of Science:

Internal Medicine
Pharmacology

Background:

Methyldopa is a common antihypertensive medication.
Its potential for causing liver toxicity is often underestimated.
Liver injury from methyldopa can be severe and life-threatening.

Purpose of the Study:

To highlight the risk of methyldopa-induced liver toxicity.
To emphasize the importance of vigilant monitoring in patients receiving methyldopa.
To present a case illustrating severe hepatotoxicity.

Main Methods:

A case report of a 45-year-old female patient with severe hypertension treated with methyldopa.
Clinical observation of liver function tests and patient's condition.
Liver biopsy to assess hepatic damage.
Follow-up assessment of liver recovery.

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Main Results:

The patient developed abnormal liver tests after 7.5 months of methyldopa treatment.
She progressed to liver failure and hepatic coma.
Liver biopsy revealed severe hepatic necrosis.
The patient slowly recovered after methyldopa discontinuation.

Conclusions:

Methyldopa can cause severe, potentially fatal, liver toxicity.
Regular monitoring for liver function is crucial for patients on methyldopa.
Early detection and discontinuation of methyldopa can prevent severe outcomes.