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Liver damage associated with perhexiline maleate

D Lewis, H C Wainwright, M C Kew

    Gut
    |March 1, 1979
    PubMed

    Insights

    Perhexiline maleate, an anti-anginal drug, caused hepatitis in two patients. Liver damage included fatty changes and features resembling alcoholic hepatitis, with one patient showing severe hepatocyte atypia.

    Area of Science:

    • Hepatology
    • Toxicology
    • Pharmacology

    Background:

    • Perhexiline maleate is an anti-anginal medication.
    • Drug-induced liver injury (DILI) is a significant concern in pharmacotherapy.

    Observation:

    • Two patients on perhexiline maleate developed hepatitis.
    • Histological examination revealed mild to moderate fatty changes and hepatitis.
    • Pathological features mimicked alcoholic hepatitis, including Mallory's hyaline-like material.

    Findings:

    • The observed Mallory's hyaline-like material showed a predominantly periportal distribution, differing from the typical centrilobular pattern in alcoholic hepatitis.
    • One patient exhibited severe hepatocyte atypia, persisting for 10 weeks post-discontinuation.
    • The second patient developed advanced hepatic fibrosis.

    Implications:

    • This case series highlights perhexiline maleate as a potential cause of DILI.
    • The distinct histological pattern may aid in diagnosing drug-induced liver injury.
    • Further investigation into the hepatotoxicity of perhexiline is warranted.

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