Diclofenac-associated hepatitis.
This patient, who had a history of osteoarthritis, had severe hepatitis 5 weeks after being started on diclofenac for increasing pain in the joints. A week before the onset of hepatitis, the patient complained of upper gastrointestinal symptoms and was treated for gastritis. Seven days later, she had full-blown, severe hepatitis. Diclofenac was immediately stopped, leading to a complete restoration of liver functions over the course of the next few months. We highlight the importance of having a high index of suspicion for hepatic side effects of diclofenac and emphasize the need for increased awareness of this rare but potentially serious problem. We also review relevant literature regarding incidence and management.
Department of Internal Medicine, University of Illinois College of Medicine at Urbana-Champaign, Urbana, USA.
A
A
Bhogaraju
S
S
Nazeer
Y
Y
Al-Baghdadi
M
M
Rahman
F
F
Wrestler
N
N
Patel
D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D004008:Diclofenac / Q000009:adverse effects*; D016903:Drug Monitoring; D005260:Female; D005756:Gastritis / Q000139:chemically induced; D006801:Humans; D008111:Liver Function Tests; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin