title: Hydroxychloroquine-induced toxic hepatitis in a patient with systemic lupus erythematosus: a case report.
abstract: Increased serum level of liver enzymes is a common finding in patients with systemic lupus erythematosus (SLE). Hepatotoxic drugs, viral hepatitis and fatty liver are thought to be the main causes of hepatic lesion in these patients. Our aim was to determine the cause of strikingly elevated liver enzymes in a case with systemic lupus presenting with acute abdomen. Liver enzyme abnormality was defined as a 10-fold or greater increase in aspartate aminotransferase and alanine aminotransferase. Acute toxic hepatitis was diagnosed, which rapidly returned to normal after cessation of the suspected causative medication, hydroxychloroquine, and subsequent administration of mycophenolate mofetil. Elevated liver enzymes are a major concern and should be well investigated in SLE patients.
authors.affiliation: Rheumatology & Rehabilitation Department, Faculty of Medicine, Zagazig University, Egypt Medicine Department, Faculty of Medicine, Umm Al-Qura University, Saudi Arabia dr_saharmahfouz@yahoo.com.
authors.forename: S M
authors.initials: SM
authors.lastname: Abdel Galil
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000201:enzymology / Q000209:etiology*; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D006886:Hydroxychloroquine; D009173:Mycophenolic Acid
keywords: Systemic lupus erythematosus; hydroxychloroquine; toxic hepatitis