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Lisinopril, used for hypertension, may cause acute hepatitis. Continuing this medication after jaundice onset can lead to severe liver failure.

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Area of Science:

  • Hepatology
  • Pharmacology
  • Internal Medicine

Background:

  • Arterial hypertension is a common condition often managed with medications like lisinopril.
  • Drug-induced liver injury (DILI) is a significant concern in pharmacotherapy.

Observation:

  • A patient developed fulminant hepatitis after 5 weeks of lisinopril treatment for arterial hypertension.
  • Symptoms included jaundice, fever, myalgia, and elevated aminotransferases within 2 weeks of starting lisinopril.

Findings:

  • Continued lisinopril administration for 3 weeks post-jaundice onset resulted in grade III hepatic encephalopathy.
  • Significant decreases in prothrombin and proaccelerin levels were noted, indicating severe coagulopathy.

Implications:

  • This case suggests lisinopril can induce acute hepatitis.
  • Discontinuation of lisinopril upon jaundice onset is crucial to prevent progression to life-threatening hepatic failure.