Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , |
Tipo de documento: | Relatório |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000300007 |
Resumo: | Introduction: Drug-induced liver injury is an increasingly prevalent consequence of the diversification of available therapeutic weapons, mostly idiosyncratic and with several possible mechanisms and patterns of specific damage for each drug. Carvedilol, a widely used non-selective alpha and beta blocker leads, in very rare cases, to injury of the bile ducts by toxic metabolites, resulting in a mixed-pattern hepatitis with possible progression to chronic cholestatic syndrome and cirrhosis. The authors report the second known case of this important toxicity. Clinical Case: An 83-year-old woman was admitted to the Internal Medicine ward for etiological clarification of a mixed-pattern hepatitis. Clinical history was unremarkable and structural, infectious, and autoimmune causes were excluded by blood tests and imaging exams, ultimately leading to the diagnosis of toxic hepatitis that was further confirmed by liver biopsy with morphologic findings of mixed-pattern liver injury. Carvedilol, started 6 months before, was deemed the causal agent since it was the only drug with a clinically, temporally, analytically, and histologically compatible pattern. The withdrawal of the drug resulted in slow reversal of the referred abnormalities. Conclusion: In very rare cases, carvedilol can cause important liver toxicity as a chronic cholestatic syndrome which can evolve to cirrhosis. It should be taken in consideration as causal agent in similar cases and stopped immediately upon suspicion, as the timely withdrawal results in reversion of the pathological findings. |
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Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical CaseCarvedilolToxic hepatitisMixed-pattern hepatitisCarvedilol-induced hepatotoxicityChronic cholestatic diseaseIntroduction: Drug-induced liver injury is an increasingly prevalent consequence of the diversification of available therapeutic weapons, mostly idiosyncratic and with several possible mechanisms and patterns of specific damage for each drug. Carvedilol, a widely used non-selective alpha and beta blocker leads, in very rare cases, to injury of the bile ducts by toxic metabolites, resulting in a mixed-pattern hepatitis with possible progression to chronic cholestatic syndrome and cirrhosis. The authors report the second known case of this important toxicity. Clinical Case: An 83-year-old woman was admitted to the Internal Medicine ward for etiological clarification of a mixed-pattern hepatitis. Clinical history was unremarkable and structural, infectious, and autoimmune causes were excluded by blood tests and imaging exams, ultimately leading to the diagnosis of toxic hepatitis that was further confirmed by liver biopsy with morphologic findings of mixed-pattern liver injury. Carvedilol, started 6 months before, was deemed the causal agent since it was the only drug with a clinically, temporally, analytically, and histologically compatible pattern. The withdrawal of the drug resulted in slow reversal of the referred abnormalities. Conclusion: In very rare cases, carvedilol can cause important liver toxicity as a chronic cholestatic syndrome which can evolve to cirrhosis. It should be taken in consideration as causal agent in similar cases and stopped immediately upon suspicion, as the timely withdrawal results in reversion of the pathological findings.Sociedade Portuguesa de Gastrenterologia2019-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000300007GE-Portuguese Journal of Gastroenterology v.26 n.3 2019reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000300007Rua,JoãoPrata,Ana RitaMarques,RicardoSilva,RafaelGomes,BráulioFraga,JoãoFortuna,Jorgeinfo:eu-repo/semantics/openAccess2024-02-06T17:33:57Zoai:scielo:S2341-45452019000300007Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:36:07.525910Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
title |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
spellingShingle |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case Rua,João Carvedilol Toxic hepatitis Mixed-pattern hepatitis Carvedilol-induced hepatotoxicity Chronic cholestatic disease |
title_short |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
title_full |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
title_fullStr |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
title_full_unstemmed |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
title_sort |
Carvedilol-Induced Liver Injury, a Rare Cause of Mixed Hepatitis: A Clinical Case |
author |
Rua,João |
author_facet |
Rua,João Prata,Ana Rita Marques,Ricardo Silva,Rafael Gomes,Bráulio Fraga,João Fortuna,Jorge |
author_role |
author |
author2 |
Prata,Ana Rita Marques,Ricardo Silva,Rafael Gomes,Bráulio Fraga,João Fortuna,Jorge |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Rua,João Prata,Ana Rita Marques,Ricardo Silva,Rafael Gomes,Bráulio Fraga,João Fortuna,Jorge |
dc.subject.por.fl_str_mv |
Carvedilol Toxic hepatitis Mixed-pattern hepatitis Carvedilol-induced hepatotoxicity Chronic cholestatic disease |
topic |
Carvedilol Toxic hepatitis Mixed-pattern hepatitis Carvedilol-induced hepatotoxicity Chronic cholestatic disease |
description |
Introduction: Drug-induced liver injury is an increasingly prevalent consequence of the diversification of available therapeutic weapons, mostly idiosyncratic and with several possible mechanisms and patterns of specific damage for each drug. Carvedilol, a widely used non-selective alpha and beta blocker leads, in very rare cases, to injury of the bile ducts by toxic metabolites, resulting in a mixed-pattern hepatitis with possible progression to chronic cholestatic syndrome and cirrhosis. The authors report the second known case of this important toxicity. Clinical Case: An 83-year-old woman was admitted to the Internal Medicine ward for etiological clarification of a mixed-pattern hepatitis. Clinical history was unremarkable and structural, infectious, and autoimmune causes were excluded by blood tests and imaging exams, ultimately leading to the diagnosis of toxic hepatitis that was further confirmed by liver biopsy with morphologic findings of mixed-pattern liver injury. Carvedilol, started 6 months before, was deemed the causal agent since it was the only drug with a clinically, temporally, analytically, and histologically compatible pattern. The withdrawal of the drug resulted in slow reversal of the referred abnormalities. Conclusion: In very rare cases, carvedilol can cause important liver toxicity as a chronic cholestatic syndrome which can evolve to cirrhosis. It should be taken in consideration as causal agent in similar cases and stopped immediately upon suspicion, as the timely withdrawal results in reversion of the pathological findings. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-06-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/report |
format |
report |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000300007 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000300007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000300007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Gastrenterologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Gastrenterologia |
dc.source.none.fl_str_mv |
GE-Portuguese Journal of Gastroenterology v.26 n.3 2019 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799137413600116736 |