title: A case of probable esomeprazole-induced transient liver injury in a pregnant woman with hyperemesis.
abstract: We report a case of 22-year-old primigravida presented to Women's Hospital - Hamad Medical Corporation emergency with severe epigastric pain, nausea, and vomiting. On admission, she was dehydrated with remarkably worsening symptoms. Laboratory findings revealed significantly elevated liver enzymes with unknown etiology. Her past medical history showed an admission for nausea and vomiting 3 weeks previously and she was discharged on antiemetics, and esomeprazole for the first time. Due to the predominantly elevated liver enzymes, the clinical pharmacist discussed the possibility of esomeprazole-induced adverse effects and suggested to suspend esomeprazole based on the evidence from literature review. The liver enzymes showed a substantial improvement within days after the discontinuation of the drug; however, a rechallenge was not done since it could have adversely affected the mother or the fetus. Using the Naranjo Adverse Drug Reaction Probability scales, the adverse reaction due to esomeprazole was classified as "probably".
authors.affiliation: Hamad Medical Corporation, Doha, Qatar; Robert Gordon University, Aberdeen, Scotland, UK; Qatar University, Doha.
authors.forename: Binny
authors.initials: B
authors.lastname: Thomas
authors.affiliation: Hamad Medical Corporation, Doha, Qatar; Qatar University, Doha; Weill Cornell Medical College, Ar-Rayyan, Qatar.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Mohamed
authors.affiliation: Hamad Medical Corporation, Doha, Qatar; Robert Gordon University, Aberdeen, Scotland, UK; Qatar University, Doha.
authors.forename: Moza
authors.initials: M
authors.lastname: Al Hail
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Fatma Alzahra Y
authors.initials: FA
authors.lastname: Awwad
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Ramy M
authors.initials: RM
authors.lastname: Wahba
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Sabir B
authors.initials: SB
authors.lastname: Hassan
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Khalid
authors.initials: K
authors.lastname: Omar
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Wessam
authors.initials: W
authors.lastname: El Kassem
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Palivalappila
authors.initials: P
authors.lastname: Abdul Rouf
keywords: ADR; adverse drug reaction; drug-induced liver injury; esomeprazole; hyperemesis; proton pump inhibitor