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Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
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Liver Injury Associated with Metamizole Exposure: Features of an Underestimated Adverse Event

Sabine Weber1, Andreas Benesic2,3,4, Jens Neumann5

  • 1Department of Medicine II, Liver Centre Munich, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Bavaria, Germany. sabine.weber@med.uni-muenchen.de.

Drug Safety
|February 27, 2021
PubMed
Abstract

Insights

Metamizole can cause drug-induced liver injury (DILI), often presenting with female predominance and hepatocellular damage. A significant percentage develop acute liver failure, highlighting the need for vigilance.

Area of Science:

  • Hepatology
  • Pharmacovigilance
  • Drug-induced liver injury (DILI)

Background:

  • Metamizole's potential to cause drug-induced liver injury (DILI) is gaining attention.
  • Understanding the specific characteristics of metamizole-induced DILI is crucial for early detection and management.

Purpose of the Study:

  • To investigate the distinguishing clinical and histopathological features of metamizole-induced DILI.
  • To identify patterns associated with severe outcomes like acute liver failure.

Main Methods:

  • Analysis of a case series of 32 patients with suspected metamizole-DILI from a larger prospective study.
  • Diagnosis confirmed by expert opinion, Roussel Uclaf Causality Assessment Method (RUCAM) score, and in vitro testing.

Main Results:

  • Metamizole-DILI cases showed female predominance, hepatocellular injury, and eosinophilic infiltration.
  • 22% of cases progressed to acute liver failure, linked to longer latency and severe biochemical abnormalities.
  • Jaundice (peak bilirubin ≥ 3 mg/dL) was common (66%) and associated with worse outcomes.

Conclusions:

  • This study supports metamizole as a cause of DILI.
  • Identified key features may help establish a signature pattern for metamizole-associated liver injury.

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