Bonito Bruno, Cartucho Joana, Silva Monica F, Ferreira Maia Inês, Ginga Maria do Rosário
Internal Medicine, Centro Hospitalar Barreiro Montijo, Barreiro, PRT.
Cureus. 2025 May 27;17(5):e84873. doi: 10.7759/cureus.84873. eCollection 2025 May.
Methyldopa is a centrally acting antihypertensive agent commonly used in the management of hypertension. It has been associated with rare but serious hepatotoxic effects. Methyldopa-induced hepatitis is an uncommon but potentially devastating adverse effect that can mimic autoimmune hepatitis (AIH) both clinically and histologically. This report presents the case of a 31-year-old woman with a history of hypertension who developed acute hepatitis following the initiation of methyldopa. The patient presented with fatigue, jaundice, and elevated liver enzymes approximately six weeks after starting therapy. Viral, autoimmune, and metabolic causes of hepatitis were excluded through comprehensive testing. Liver function normalized following the discontinuation of methyldopa, and the patient recovered fully, supporting a diagnosis of drug-induced liver injury (DILI). Causality was assessed using the Roussel Uclaf Causality Assessment Method (RUCAM), yielding a score of 9, indicating a 'highly probable' link between methyldopa and the observed hepatitis.
甲基多巴是一种中枢性降压药，常用于高血压的治疗。它与罕见但严重的肝毒性作用有关。甲基多巴诱发的肝炎是一种不常见但可能具有毁灭性的不良反应，在临床和组织学上都可能类似自身免疫性肝炎（AIH）。本报告介绍了一名31岁有高血压病史的女性，在开始使用甲基多巴后发生急性肝炎的病例。患者在开始治疗约六周后出现疲劳、黄疸和肝酶升高。通过全面检查排除了肝炎的病毒、自身免疫和代谢原因。停用甲基多巴后肝功能恢复正常，患者完全康复，支持药物性肝损伤（DILI）的诊断。使用鲁塞尔·乌克拉夫因果关系评估法（RUCAM）评估因果关系，得分为9分，表明甲基多巴与观察到的肝炎之间有“高度可能”的联系。
