Singh Harjit, Khalaf Adam, Kunkle Bryce F, Gholami Sherry, Lewis James H, Rangnekar Amol S
Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC.
Department of Gastroenterology and Hepatology, Medstar Georgetown University Hospital, Washington, DC.
ACG Case Rep J. 2024 Dec 30;12(1):e01570. doi: 10.14309/crj.0000000000001570. eCollection 2025 Jan.
Statin-induced liver injury has been widely described. However, cases of clinically significant liver injury are rare. We present a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury with concurrent rhabdomyolysis that worsened after rechallenging, which highlighted the need for pharmacovigilance with statins. The Roussel Uclaf Causality Assessment Method and Revised Electronic Causality Assessment Method both showed that atorvastatin was highly probable in causing hepatotoxicity. To our knowledge, this is the first reported case of concurrent drug-induced liver injury and rhabdomyolysis after a positive rechallenge with atorvastatin.
他汀类药物所致肝损伤已有广泛报道。然而，具有临床意义的肝损伤病例较为罕见。我们报告了一名56岁女性，她发生了阿托伐他汀所致的III级急性肝损伤，并伴有横纹肌溶解，再次用药后病情加重，这凸显了他汀类药物进行药物警戒的必要性。鲁塞尔·优克福因果关系评估法（RUCAM）和改良电子因果关系评估法（RECAM）均显示阿托伐他汀极有可能导致肝毒性。据我们所知，这是首次报道阿托伐他汀再次用药阳性后并发药物性肝损伤和横纹肌溶解的病例。
