RESUMO
The use of new oral anticoagulants such as apixaban is increasing. We present the case of an 85-year-old patient who was diagnosed with mixed profile toxic hepatitis due to apixaban use. An etiological study was negative, except for anti-smooth muscle antibodies, and a liver biopsy ruled out autoimmune hepatitis. The patient was assigned a score of 7 on the CIOMS/RUCAM scale, indicating a probable causality. The liver injury improved after the withdrawal of apixaban. A previous meta-analysis reported that the risk of hepatotoxicity does not increase with the use of apixaban, nor were any cases reported in registry studies. Nonetheless, more than 120 possible cases currently appear in the European pharmacovigilance database (EudraVigilance). We suggest that apixaban should be considered as a possible cause of liver injury.
Assuntos
Doença Hepática Crônica Induzida por Substâncias e Drogas/etiologia , Inibidores do Fator Xa/efeitos adversos , Pirazóis/efeitos adversos , Piridonas/efeitos adversos , Idoso de 80 Anos ou mais , Biópsia , Doença Hepática Crônica Induzida por Substâncias e Drogas/patologia , Humanos , Fígado/patologia , MasculinoAssuntos
Doença de Gilbert/complicações , Cirrose Hepática/etiologia , Síndrome de Turner/complicações , Estrogênios/efeitos adversos , Estrogênios/uso terapêutico , Feminino , Doença de Hashimoto/complicações , Doença de Hashimoto/tratamento farmacológico , Terapia de Reposição Hormonal/efeitos adversos , Hormônio do Crescimento Humano/administração & dosagem , Hormônio do Crescimento Humano/uso terapêutico , Humanos , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/patologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia , Progesterona/efeitos adversos , Progesterona/uso terapêutico , Tiroxina/uso terapêutico , Síndrome de Turner/tratamento farmacológico , Adulto JovemRESUMO
Recently, several cases of hepatic glycogenosis (HG) have been reported. García-Suárez et al. described a young female patient with poorly controlled type 1 diabetes, right upper quadrant pain and elevated serum transaminases and GGT. After other causes of liver disease were excluded and a liver biopsy was performed, the patient was diagnosed with HG. HG is rare and can be misdiagnosed as steatohepatitis. To date, less than 20 cases have been reported in adults.