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    Area of Science:

    • Hepatology
    • Toxicology
    • Pharmacology

    Background:

    • Salicylate therapy is commonly used for inflammatory conditions.
    • Acute hepatic injury is a rare but serious adverse effect of salicylate treatment.

    Observation:

    • Two patients on high-dose salicylate therapy developed acute hepatic injury.
    • Serum salicylate levels were below 25 mg/100 ml during hepatic dysfunction.
    • Liver biopsies showed nonspecific acute hepatitis.

    Findings:

    • Rechallenge with salicylates in one patient precipitated recurrent hepatic dysfunction.
    • Salicylate-induced liver injury occurred independently of serum salicylate concentration.

    Implications:

    • Consider salicylate-induced liver injury in patients with hepatic dysfunction on high-dose salicylate therapy.
    • Monitoring liver function is crucial for patients receiving long-term salicylate treatment.