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[Diclofenac-associated acute cholestatis hepatitis]

H Hackstein1, W Mohl, W Püschel

  • 1Klinik für Innere Medizin II, Universitätskliniken des Saarlandes

Zeitschrift Fur Gastroenterologie
|July 9, 1998
PubMed
Summary

Diclofenac, a common anti-inflammatory drug, can cause severe liver injury (hepatotoxicity). This case highlights the importance of considering diclofenac toxicity in diagnosing acute cholestatic hepatitis.

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Area of Science:

  • Hepatology
  • Clinical Pharmacology

Background:

  • Diclofenac is a widely prescribed nonsteroidal anti-inflammatory drug (NSAID) for inflammatory conditions.
  • Diclofenac-induced liver injury (DILI) is a known adverse effect, ranging from mild transaminase elevations to severe hepatitis.
  • Previous reports document diclofenac-associated hepatitis, including fatal cases.

Observation:

  • A 64-year-old patient presented with acute icteric hepatitis.
  • The patient had been taking diclofenac (150-200 mg daily) for spondylodiscitis.
  • Diagnostic workup, including ERCP, laparoscopy, and liver biopsy, ruled out other causes of cholestatic hepatitis.

Findings:

  • Discontinuation of diclofenac led to normalization of liver enzymes and bilirubin within four months.
  • The patient's presentation and recovery strongly suggest diclofenac as the causative agent.

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  • This case adds to the literature on diclofenac-induced cholestatic liver injury.

    • Implications:

    • Diclofenac hepatotoxicity is a serious concern, even with short-term use.
    • Clinicians should consider diclofenac toxicity in the differential diagnosis of acute cholestatic hepatitis.
    • Awareness of this potential adverse effect is crucial for patient safety and effective management.