Perhexiline maleate-induced hepatitis.

Area of Science:

• Hepatology
• Toxicology
• Pharmacology

Background:

• Perhexiline maleate is a medication used for certain cardiovascular conditions.
• Understanding drug-induced liver injury (DILI) is crucial for patient safety.

Observation:

• Five patients treated with perhexiline maleate (200-400 mg/day for ≥6 months) developed hepatitis.
• The clinical, biological, and histological features resembled acute alcoholic hepatitis.

Findings:

• Hepatitis presentation included necrosis, Mallory's hyaline, polynuclear infiltration, and steatosis.
• Concurrent peripheral neuropathy, hypoglycemia, and renal failure were frequently observed.
• Three patients died within six months, despite drug withdrawal, indicating severe outcomes.

Implications:

• Perhexiline maleate poses significant risks for hepatic and neurologic toxicity.
• Further research is needed to elucidate the mechanisms of perhexiline toxicity.
• Findings may offer insights into alcohol-induced liver toxicity mechanisms.