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Cholestatic hepatitis after diagnostic ajmaline challenge.
1Service de Gastroentérologie, Grand Hopital de Charleroi, Charleroi, Belgium.
Acta Gastro-Enterologica Belgica
|March 22, 2018
Summary
Ajmaline challenge during Brugada syndrome testing caused cholestatic hepatitis in an elderly woman. This rare drug-induced liver injury resolved quickly after stopping the medication.
Area of Science:
- Hepatology
- Clinical Electrophysiology
- Pharmacology
Background:
- Brugada syndrome is a rare genetic disorder affecting heart rhythm.
- Ajmaline is an antiarrhythmic drug used in diagnostic electrophysiological testing.
- Drug-induced liver injury (DILI) is a significant clinical concern.
Observation:
- An elderly woman developed jaundice and elevated liver enzymes after ajmaline administration.
- No other potential hepatotoxic agents were identified.
- Liver biopsy confirmed cholestatic hepatitis with mild biliary damage.
Findings:
- Intravenous ajmaline can induce cholestatic hepatitis.
- Histological evidence supports ajmaline as the causative agent.
- The condition showed rapid improvement upon drug withdrawal.
Implications:
- Clinicians should consider ajmaline-induced liver injury in patients with unexplained hepatitis post-testing.
- Further research into the hepatotoxicity of antiarrhythmic drugs is warranted.
- Early recognition and management are crucial for favorable outcomes.
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