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Pantoprazole induces severe acute hepatitis
C Sandig1, C Flechtenmacher, W Stremmel
1Department of Gastroenterology and Hepatology, University Hospital of Heidelberg, Heidelberg, Germany. Catharina.Sandig@med.uniheidelberg.de
Pantoprazole, a proton pump inhibitor, can cause severe acute hepatitis in patients undergoing corticosteroid therapy for encephalomyelitis disseminata. Discontinuation of pantoprazole led to patient recovery, suggesting drug-induced liver injury.
Area of Science:
- Hepatology
- Pharmacology
- Neurology
Background:
- Corticosteroid therapy is used for encephalomyelitis disseminata.
- Pantoprazole is a commonly prescribed proton pump inhibitor.
Observation:
- A patient on pantoprazole and corticosteroids developed severe acute hepatitis.
- Exclusion of other liver dysfunction causes was performed.
- Liver biopsy revealed extensive hepatocellular necrosis.
Findings:
- Pantoprazole treatment was associated with severe acute hepatitis.
- Discontinuation of pantoprazole resulted in liver function improvement and full recovery.
- A previous milder hepatitis episode with pantoprazole was noted.
Implications:
- Pantoprazole may cause idiosyncratic drug-induced liver injury.
- Clinicians should monitor liver function in patients using pantoprazole, especially with concurrent corticosteroid therapy.
- This case highlights the potential hepatotoxicity of pantoprazole.
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