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Nimesulide-induced acute hepatitis: evidence from six cases
W Van Steenbergen1, P Peeters, J De Bondt
1Department of Internal Medicine, University Hospital Gasthuisberg-St Rafaël, Catholic University of Leuven, Belgium.
Journal of Hepatology
|August 8, 1998
Summary
Nimesulide, a nonsteroidal anti-inflammatory drug, can cause acute liver damage. This study reports six cases of nimesulide-induced liver injury, presenting as hepatocellular necrosis or cholestasis.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause liver injury.
- Nimesulide, a selective cyclooxygenase-2 inhibitor, has not been well-documented for causing acute hepatitis.
- This study investigates liver damage associated with nimesulide use.
Observation:
- Six patients developed liver injury after starting nimesulide.
- Presentations included hepatocellular necrosis and intrahepatic cholestasis.
- Jaundice was a common symptom, with some cases showing hypersensitivity indicators.
Findings:
- The causal link between nimesulide and liver injury was probable to highly probable in most cases.
- One patient with hepatocellular necrosis and one with cholestasis showed hypersensitivity.
- Liver function normalized in most patients within 6-17 months.
Implications:
- Nimesulide-induced liver injury can manifest as hepatocellular necrosis or cholestasis.
- Both immunologic and metabolic idiosyncratic reactions may underlie nimesulide hepatotoxicity.
- Clinicians should be aware of potential nimesulide liver damage.