title: Dapagliflozin-Induced Acute-on-Chronic Liver Injury.
abstract: Sodium-glucose cotransporter 2 inhibitors are a new class of oral hypoglycemic agents, and thus safety data are limited. We present a 48-year-old woman with type 2 diabetes mellitus and Child's Class A cirrhosis secondary to nonalcoholic steatohepatitis presenting with jaundice and acute cholestatic liver injury. Other than starting dapagliflozin, she reported no medication changes or supplement use. Before treatment, her total bilirubin was 1.2 mg/dL. On admission, her liver values were elevated and liver biopsy was consistent with drug-induced liver injury. This report raises awareness about the potential hepatotoxic effects of dapagliflozin, particularly in patients with chronic liver disease.
authors.affiliation: Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Levine
authors.affiliation: Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Amy
authors.initials: A
authors.lastname: Ann Lo
authors.affiliation: Division of Endocrinology, Metabolism and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Amisha
authors.initials: A
authors.lastname: Wallia
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Melinda
authors.initials: M
authors.lastname: Rogers
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: VanWagner