Drug-induced hepatitis treated with corticosteroids – a clinical case report
Keywords:
drug-induced hepatitis, nimesulide, corticosteroidsAbstract
The authors report the case of a 46 year-old female, with no
relevant pathological background, who was prescribed cefuroxime
axetil and nimesulide, and fi fteen days later, developed general
malaise, asthenia, jaundice and coluria.
On being hospitalized, the patient showed an increase of
transaminases (ALT= 1747 UI/l) and hyperbilirubinaemia (total
bil. = 4.6 mg/dl). As the condition evolved, the jaundice became
worse and the total bilirubin reached 18.5 mg/dl.
The aetiological investigation of the patient’s liver disease
excluded the most common bacterial and viral agents, as well
as the autoimmune and metabolic causes. Liver biopsy was
compatible with Acute Hepatitis. With the hypothesis of acute
iatrogenic hepatitis being considered, all drugs were suspended.
The clinical picture remained unresolved and corticotherapy was
introduced with good clinical results.
The authors made a revision of the pathogenesis of drug-induced hepatitis and they discuss this case of acute hepatitis
caused by nimesulide. They also review the use of corticotherapy
in drug-induced hepatitis.
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