Pantoprazole-induced acute hepatocellular and cholestatic hepatitis

Introduction Pantoprazole is a proton pump inhibitor (PPI) widely used to manage acid-related disorders. It is well tolerated with an excellent safety profile.1 Mild, transient asymptomatic elevations in serum aminotransferases is common with pantoprazole use. They typically resolve without dose modification.1 Pantoprazole-induced clinically apparent liver injury, however, is exceedingly rare. We demonstrate a case of acute, severe symptomatic liver injury from pantoprazole use that reversed on its discontinuation. Case presentation A 47-year-old Caucasian woman with no history of liver disease was admitted to the hospital with elevated aminotransferases. She was prescribed pantoprazole 40 mg/day 2 months previously for gastritis, at which point liver function tests were normal. Two weeks after initiation of pantoprazole, she began developing nausea, abdominal pain and jaundice. Pantoprazole was subsequently discontinued a week prior to her presentation. Additional medications included levothyroxine 88 mcg/day, hydrochlorothiazide 12.5 mg/day, enalapril 10 mg/day and aspirin 81 mg/day....
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Adverse drug reactions Source Type: research