geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Acute Cholestatic Liver Injury From Hydralazine Intake


, : Acute Cholestatic Liver Injury From Hydralazine Intake. American Journal of Therapeutics 23(5): E1211-4

Hydralazine is a commonly used oral antihypertensive agent. We report a rare case of hydralazine-induced hepatotoxicity in the form of subacute hepatic necrosis. A 75-year-old African American woman presented with jaundice of 7-day duration. She was started on hydralazine 100 mg 3 times a day 10 weeks before presentation. On physical examination, scleral icterus was noted. Workup revealed elevated liver transaminases, alkaline phosphatase, and conjugated bilirubin. She had no history of liver disease, and liver function tests had been normal before starting hydralazine. Other etiologies, including viruses, common toxins, drugs, autoimmune, and copper-induced hepatitis, were excluded. Abdominal imaging studies did not show any evidence of intrahepatic or extrahepatic biliary ductal dilatation, and no pathologies were seen in the liver and pancreas. The patient's liver biopsy revealed extensive lobular hepatitis, significant necrosis, mixed inflammatory infiltrate, and no significant fibrosis, supporting a diagnosis of drug-induced liver injury. Hydralazine was immediately discontinued. She showed improvement of clinical and laboratory abnormalities within 5 days after discontinuation of hydralazine. To establish the diagnosis of hydralazine-induced liver injury, we used assessment tool outlined by the Council for International Organization of Medical Sciences (CIOMS) scale that led to "high probable" relationship. Although rare, clinically significant, and potentially life-threatening liver injury can result from use of hydralazine. Both clinical and histological presentations in our patient suggest acute liver injury. The hydralazine-induced hepatitis seems to be reversible as discontinuation of the drug improves clinical outcomes. We highly recommend monitoring of the liver function during hydralazine treatment.

US$19.90

PMID: 26291593

DOI: 10.1097/MJT.0000000000000310


Other references

Torigoe, T.; Akiyama, Y.; Uehara, T.; Nakayama, Y.; Yamaguchi, K., 2013: Laparoscopic colectomy for transverse colon cancer in an automated peritoneal dialysis patient: A case report. To date, intra-abdominal surgery in patients undergoing peritoneal dialysis (PD) has been considered to be associated with increased risk even when it is performed laparoscopically. To our knowledge, this is the first case of laparoscopic colectom...

Golomb; Rubin; Sompolinsky, 1990: Willshaw model: Associative memory with sparse coding and low firing rates. Physical Review. A, Atomic, Molecular, and Optical Physics 41(4): 1843-1854

Jelínek, R.; Seifertová, M.; Tykva, R., 1977: Varying distribution of 6-azauridine within the mouse foetoplacental unit. The distribution of labeled 6-azauridine administered i.m. together with an embryotoxic (25 mg) dose of unlabeled 6-azauridine, or after the injection of an embryotoxic dose (250 .mu.g) into the immediate vicinity of a fetus, was studied in random...

Miura, H., 2009: Differences in frontal lobe function between violent and nonviolent conduct disorder in male adolescents. The common features of autism spectrum disorder, a highly heritable representative pervasive developmental disorder with significant heterogeneity and multiple-genetic factors, are severe dysfunction in social reciprocity, abnormalities in social...

Toyoda, M.; Jitsumori, K.; Mikami, B.; Wackett, L.P.; Kurihara, T.; Esaki, N., 2010: Crystallization and preliminary X-ray analysis of L-azetidine-2-carboxylate hydrolase from Pseudomonas sp. strain A2C. L-Azetidine-2-carboxylate hydrolase from Pseudomonas sp. strain A2C catalyzes a ring-opening reaction that detoxifies L-azetidine-2-carboxylate, an analogue of L-proline. Recombinant L-azetidine-2-carboxylate hydrolase was overexpressed, purified...

Rostom, Zmf, 1974: Haemocytes and total haemolymph carbohydrate of Pectinophora gossypiella during induction and termination of diapause. Proceedings Egypt Sci: 81-88

Malara, P., 2005: The presence of elements in human teeth during some diseases: Part I. General diseases. Tooth hard tissues have an ability to accumulate many elements in their structure. There may be a change in the content and coexistence pattern of elements in teeth in the course of diseases of tooth hard tissues and systemic diseases. It is known...

Watkins, C.C.; Pieper, A.A.; Treisman, G.J., 2011: Safety considerations in drug treatment of depression in HIV-positive patients: an updated review. Major depressive disorder (MDD) is one of the most prevalent illnesses associated with HIV infection, and negatively affects medication adherence, disease progression and mortality in HIV disease. Co-morbid treatment of major depression in HIV dis...

Dethier M., 1974: Revision of the heteroptera described by cerutti. Revue Suisse de Zoologie 81(3): 667-672

Matveev, Na, 1977: Growing Eurotia Adans in a nursery. Lesnoe khoziaistvo: 64-65