A Rare Case of Dapagliflozin-Induced Hepatic Toxicity

Um Caso Raro de Toxicidade Hepática Induzida por Dapagliflozina

Abstract

Drug-induced liver injury is a challenging clinical condition in terms of both diagnosis and treatment. It presents a wide range of clinical manifestations, and identification of the implicated substance is crucial. Several adverse effects have been described in association with dapagliflozin, but not liver enzyme elevation. The authors present the case of a 71-year-old diabetic woman who developed gastrointestinal symptoms one month after increasing the dose of dapagliflozin. Liver enzyme elevation was observed, without evidence of obstructive causes on imaging exams. Other causes of liver disease were excluded, and liver biopsy favored a toxic/drug etiology. Liver enzyme normalization was observed after discontinuation of dapagliflozin. Liver injury associated with sodium-glucose cotransporter 2 inhibitors is very rare, and the authors aim to raise awareness about the potential hepatotoxic effects of dapagliflozin, highlighting the importance of early diagnosis and appropriate treatment.