Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review

Lisinopril is an angiotensin converting enzyme inhibitor (ACE-I) that has been on market for more than 25 years. ACE-I are usually well tolerated and rarely have serious or life-threatening side effects. We describe an unusual presentation of fulminant hepatic cholestasis probably secondary to lisin...

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Main Authors: Ammar Al-Rifaie, Mir Azam Khan, Amjad Ali, Asha Kumari Dube, Dermot Gleeson, Barbara Hoeroldt
Format: Article
Language:English
Published: SMC MEDIA SRL 2020-04-01
Series:European Journal of Case Reports in Internal Medicine
Subjects:
Online Access:https://www.ejcrim.com/index.php/EJCRIM/article/view/1600
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spelling doaj-39ccdc4bbafb45a3a022d47047d8fdf42020-11-25T03:15:49ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942020-04-0110.12890/2020_0016001242Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature ReviewAmmar Al-Rifaie0Mir Azam Khan1Amjad Ali2Asha Kumari Dube3Dermot Gleeson4Barbara Hoeroldt5Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UKLisinopril is an angiotensin converting enzyme inhibitor (ACE-I) that has been on market for more than 25 years. ACE-I are usually well tolerated and rarely have serious or life-threatening side effects. We describe an unusual presentation of fulminant hepatic cholestasis probably secondary to lisinopril. To our knowledge, this is the second case report which shows lisinopril-induced liver injury though a cholestatic mechanism. The patient was a 59-year-old woman with type 2 diabetes, a high body mass index and hypertension, who presented with a 5-week history of jaundice and itching. She had been started on lisinopril for diabetic nephropathy 8 weeks before admission. Other causes for cholestasis had been excluded through non-invasive immunology and virology screening, an ultrasound of the liver, magnetic resonance cholangiopancreatography and a liver biopsy. The biopsy was consistent with drug-induced liver injury. Lisinopril was stopped 2 weeks before admission. The patient’s hospital stay was complicated by contrast nephropathy and influenza A which were both treated appropriately. Unfortunately, the liver cholestasis did not completely resolve following withdrawal of lisinopril and the patient died after 4 months. A literature search yielded only six other reported cases of lisinopril-induced liver injury. Five cases described hepatocellular damage and one showed cholestatic injury.https://www.ejcrim.com/index.php/EJCRIM/article/view/1600angiotensin converting enzyme inhibitorslisinoprildrug-induced liver injurycholestasis
collection DOAJ
language English
format Article
sources DOAJ
author Ammar Al-Rifaie
Mir Azam Khan
Amjad Ali
Asha Kumari Dube
Dermot Gleeson
Barbara Hoeroldt
spellingShingle Ammar Al-Rifaie
Mir Azam Khan
Amjad Ali
Asha Kumari Dube
Dermot Gleeson
Barbara Hoeroldt
Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review
European Journal of Case Reports in Internal Medicine
angiotensin converting enzyme inhibitors
lisinopril
drug-induced liver injury
cholestasis
author_facet Ammar Al-Rifaie
Mir Azam Khan
Amjad Ali
Asha Kumari Dube
Dermot Gleeson
Barbara Hoeroldt
author_sort Ammar Al-Rifaie
title Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review
title_short Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review
title_full Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review
title_fullStr Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review
title_full_unstemmed Lisinopril-Induced Liver Injury: An Unusual Presentation and Literature Review
title_sort lisinopril-induced liver injury: an unusual presentation and literature review
publisher SMC MEDIA SRL
series European Journal of Case Reports in Internal Medicine
issn 2284-2594
publishDate 2020-04-01
description Lisinopril is an angiotensin converting enzyme inhibitor (ACE-I) that has been on market for more than 25 years. ACE-I are usually well tolerated and rarely have serious or life-threatening side effects. We describe an unusual presentation of fulminant hepatic cholestasis probably secondary to lisinopril. To our knowledge, this is the second case report which shows lisinopril-induced liver injury though a cholestatic mechanism. The patient was a 59-year-old woman with type 2 diabetes, a high body mass index and hypertension, who presented with a 5-week history of jaundice and itching. She had been started on lisinopril for diabetic nephropathy 8 weeks before admission. Other causes for cholestasis had been excluded through non-invasive immunology and virology screening, an ultrasound of the liver, magnetic resonance cholangiopancreatography and a liver biopsy. The biopsy was consistent with drug-induced liver injury. Lisinopril was stopped 2 weeks before admission. The patient’s hospital stay was complicated by contrast nephropathy and influenza A which were both treated appropriately. Unfortunately, the liver cholestasis did not completely resolve following withdrawal of lisinopril and the patient died after 4 months. A literature search yielded only six other reported cases of lisinopril-induced liver injury. Five cases described hepatocellular damage and one showed cholestatic injury.
topic angiotensin converting enzyme inhibitors
lisinopril
drug-induced liver injury
cholestasis
url https://www.ejcrim.com/index.php/EJCRIM/article/view/1600
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AT ashakumaridube lisinoprilinducedliverinjuryanunusualpresentationandliteraturereview
AT dermotgleeson lisinoprilinducedliverinjuryanunusualpresentationandliteraturereview
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