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Drug-Induced Hepatitis Caused by Methylphenidate: A Case Report

Diana Valbom Gonçalves1, Mariana Bravo2, Sónia Almeida1

  • 1Department of Pediatrics. Unidade Local de Saúde Aveiro. Aveiro. Portugal.

Acta Medica Portuguesa
|December 17, 2025
PubMed

Insights

Methylphenidate (MPH) can cause rare liver damage in children with attention deficit hyperactivity disorder (ADHD). Regular monitoring is crucial to detect drug-induced hepatitis early and prevent serious complications.

Area of Science:

  • Pediatric Pharmacology
  • Hepatology
  • Neuropsychiatry

Background:

  • Methylphenidate (MPH) is a first-line psychostimulant for Attention Deficit Hyperactivity Disorder (ADHD).
  • While generally safe, rare instances of hepatotoxicity associated with MPH treatment have been reported.
  • Adverse effects of MPH are typically transient, but liver injury can be a serious concern.

Purpose of the Study:

  • To report a case of drug-induced hepatitis in a pediatric patient treated with MPH.
  • To highlight the importance of monitoring liver function during long-term MPH therapy.
  • To emphasize the need for early detection and intervention to prevent severe liver complications.

Main Methods:

  • Case presentation of a 12-year-old female with ADHD on long-term MPH therapy.
  • Biochemical assessment including liver enzymes (transaminases, gamma-glutamyl transferase).
  • Liver biopsy to confirm drug-induced hepatitis after excluding other causes.

Main Results:

  • The patient exhibited marked elevation in liver enzymes after 3.5 years of MPH treatment.
  • Liver biopsy confirmed drug-induced hepatitis.
  • Discontinuation of MPH led to normalization of liver enzyme levels.

Conclusions:

  • Long-term MPH therapy necessitates regular laboratory monitoring for liver function in pediatric patients.
  • Early identification of elevated liver enzymes is critical for prompt MPH discontinuation.
  • Timely intervention can reverse hepatic injury and prevent progression to liver failure.
Keywords:
AdolescentAttention Deficit Disorder with Hyperactivity/drug therapyChemical and Drug Induced Liver Injury/diagnosisChemical and Drug Induced Liver Injury/etiologyMethylphenidate/adverse effects

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