Idiosyncratic Drug-Induced Liver Injury in a Healthy Patient following PCSK9-Inhibitor Injection

Area of Science:

• Hepatology
• Pharmacology
• Nephrology

Background:

• Acute liver injury (ALI) presents a critical medical challenge with diverse causes.
• Prompt, multidisciplinary intervention is crucial for managing ALI patients.
• Identifying the etiology and initiating timely treatment are vital for patient survival.

Observation:

• A 66-year-old male developed ALI after receiving inclisiran for hypercholesterolemia.
• The patient presented to University Hospital Essen in October 2022 with acute liver injury.
• Initial treatment involved short-term cortisol therapy and open albumin (OPAL) dialysis.

Findings:

• This case represents the first reported instance of ALI linked to inclisiran administration.
• The combination therapy of cortisol and OPAL dialysis proved effective in treating inclisiran-induced ALI.
• The patient achieved full recovery with normalized liver, kidney, and coagulation function at discharge.

Implications:

• Inclisiran should be considered a potential cause of acute liver injury.
• Cortisol combined with OPAL dialysis offers a viable treatment strategy for inclisiran-induced ALI.
• This case highlights the importance of recognizing and managing rare drug-induced liver injuries.