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Cimetidine hepatitis.

J T Schwartz, F Gyorkey, D Y Graham

    Journal of Clinical Gastroenterology
    |December 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Cimetidine can cause asymptomatic hepatitis, a rare condition characterized by liver cell damage and bile stasis. Re-exposure confirmed the diagnosis, suggesting limited benefit from routine liver function monitoring during cimetidine therapy.

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    Area of Science:

    • Hepatology
    • Gastroenterology
    • Clinical Pharmacology

    Background:

    • Cimetidine, a histamine H2 receptor antagonist, is commonly prescribed for duodenal ulcer disease.
    • Drug-induced liver injury (DILI) is a significant concern in clinical practice.
    • Asymptomatic liver injury can occur during medication therapy.

    Observation:

    • A 62-year-old male patient developed asymptomatic anicteric hepatitis during cimetidine treatment.
    • Liver biopsy showed zonal necrosis, bile stasis, and inflammatory cell infiltration.
    • Electron microscopy revealed mitochondrial changes and intracellular bile inclusions.

    Findings:

    • Re-challenge with cimetidine led to a rapid increase in serum transaminases, confirming cimetidine-induced hepatitis.
    • Cimetidine hepatitis is a rare adverse effect, infrequently reported in medical literature.

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  • Histopathological findings included centrolobular necrosis and cholestasis.

    • Implications:

    • This case highlights a rare but serious adverse effect of cimetidine.
    • Routine liver function monitoring for all patients on cimetidine may not be cost-effective.
    • Clinicians should maintain a high index of suspicion for drug-induced hepatitis in patients on cimetidine presenting with abnormal liver tests.