Venlafaxine-induced cholestatic hepatitis: case report and review of literature.
Venlafaxine is a widely used antidepressant with relatively low occurrence of adverse side effects. Increasing evidence suggests that venlafaxine may cause severe liver damage. Until now, 10 cases of venlafaxine-related liver injuries have been reported. We describe a case of a 39-year-old woman who developed cholestatic hepatitis after intake of venlafaxine. The patient had taken low-dose venlafaxine (75 mg/d) for 2.5 years. Three months before admission to the hospital, the venlafaxine dosage had been increased to 300 mg/d because of severe depression. Laboratory findings revealed elevated serum transaminases (aspartate aminotransferase 1033 U/L; alanine aminotransferase 2063 U/L), alkaline phosphatase (274 U/L), γ-glutamyltransferase (284 U/L), and serum bilirubin (4.6 mg/dL). Liver biopsy showed cholestatic hepatitis predominantly involving zone 3 of hepatic acini and a mixed portal inflammatory infiltrate along with eosinophils. Symptoms rapidly resolved after cessation of venlafaxine and administration of corticosteroid. The present paper describes detailed clinicohistopathologic characteristics of venlafaxine-associated cholestatic hepatitis and provides a comprehensive summary of prior case reports.
Institute of Pathology, Kantonsspital Baden, Baden, Switzerland. sylvia.stadlmann@ksb.ch
Sylvia
S
Stadlmann
Susanne
S
Portmann
Stefan
S
Tschopp
Luigi M
LM
Terracciano
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D001706:Biopsy; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000473:pathology; D003511:Cyclohexanols / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride