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[Enalapril (Reniten)-associated toxic hepatitis]
R Hürlimann1, J Binek, C Oehlschlegel
1Gastroenterologische Abteilung, Medizinische Klinik C, Kantonsspital St. Gallen.
Schweizerische Medizinische Wochenschrift
|July 23, 1994
Summary
Enalapril, a hypertension medication, may cause acute toxic hepatitis. This drug-induced liver injury resolved after discontinuing enalapril, suggesting a link between the medication and liver damage.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Toxicology
Background:
- Hypertension management often involves medications like enalapril.
- Drug-induced liver injury (DILI) is a significant clinical concern.
- Identifying causative agents in DILI is crucial for patient recovery.
Observation:
- A 52-year-old female presented with jaundice, malaise, and vomiting.
- Elevated liver enzymes and bilirubin, with prolonged thromboplastin time, were noted.
- Viral and other causes of hepatitis were ruled out through serological and imaging studies.
Findings:
- Liver biopsy revealed fulminant hepatitis, consistent with drug-induced liver injury.
- Cessation of enalapril led to complete recovery of liver function.
- Acute toxic hepatitis attributed to enalapril was diagnosed, likely via an idiosyncratic reaction.
Implications:
- Enalapril should be considered as a potential cause of acute toxic hepatitis.
- This case highlights the importance of considering medication side effects in unexplained liver injury.
- Further investigation into the mechanisms of enalapril-induced hepatotoxicity is warranted.