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Atorvastatin-Induced Liver Injury With Concurrent Rhabdomyolysis After a Positive Rechallenge
Harjit Singh1, Adam Khalaf1, Bryce F Kunkle1
1Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC.
ACG Case Reports Journal
|January 1, 2025
Summary
This case report details a rare instance of severe atorvastatin-induced liver injury and rhabdomyolysis. The adverse event recurred upon rechallenge, emphasizing the need for vigilant monitoring of statin medications.
Area of Science:
- Pharmacology
- Hepatology
- Toxicology
Background:
- Statins are widely prescribed lipid-lowering drugs.
- While statin-induced liver injury is known, clinically significant cases are infrequent.
- Pharmacovigilance is crucial for identifying and managing adverse drug reactions.
Observation:
- A 56-year-old woman experienced grade III acute liver injury and rhabdomyolysis.
- These symptoms were associated with atorvastatin use.
- The condition worsened upon rechallenge with atorvastatin.
Findings:
- Causality assessment methods (RUCAM and RECAM) indicated a high probability of atorvastatin causing hepatotoxicity.
- This represents the first reported case of concurrent drug-induced liver injury and rhabdomyolysis following a positive atorvastatin rechallenge.
- The rechallenge confirmed the drug's role in the adverse events.
Implications:
- This case underscores the importance of careful patient monitoring during statin therapy.
- It highlights the potential for severe, concurrent hepatotoxicity and myotoxicity with atorvastatin.
- Enhanced pharmacovigilance strategies are needed for statin-associated adverse events.
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