Hepatitis and hematemesis complicating nicotinic acid use.
Nicotinic acid has a proven efficacy in the treatment of hypercholesterolemia. Therapeutic use of this water-soluble B vitamin has resulted in a survival benefit among patients enrolled in the Coronary Drug Project. Conversely, nicotinic acid has been associated with a high side-effect profile when used at therapeutic doses. Nevertheless, there are no previously reported cases of hematemesis temporally associated with nicotinic acid use. The authors report the case of a previously healthy 20-year-old man who developed hematemesis and hepatitis 1 week after self-initiating the daily consumption of 6 g of nicotinic acid. Supportive therapy and discontinuing nicotinic acid resulted in rapid clinical improvement in this patient. The clinical circumstances suggest a possible causal relationship between nicotinic acid consumption and his presenting problems. The use of large doses of nicotinic acid may be rapidly complicated by hematemesis and hepatitis.
Ferenchick
G
G
Department of Medicine, Michigan State University, East Lansing 48824.
Rovner
D
D
D000328:Adult; D056486:Chemical and Drug Induced Liver Injury / Q000097:blood / Q000503:physiopathology; D006396:Hematemesis / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D009525:Niacin / Q000009:adverse effects*; D011517:Prothrombin Time; D012651:Self Medication
D009525:Niacin