[Enalapril (Reniten)-associated toxic hepatitis]

Publication

[Enalapril (Reniten)-associated toxic hepatitis]

Journal Paper/Review - Jul 23, 1994

Hürlimann R, Binek Janek, Öhlschlegel Christian, Hammer B

Units

Gastroenterology/Hepatology, Pathologie

PubMed

8066414

Citation

Hürlimann R, Binek J, Öhlschlegel C, Hammer B. [Enalapril (Reniten)-associated toxic hepatitis]. Schweizerische medizinische Wochenschrift 1994; 124:1276-80.

Type

Journal Paper/Review (English)

Journal

Schweizerische medizinische Wochenschrift 1994; 124

Publication Date

Jul 23, 1994

Issn Print

0036-7672

Pages

1276-80

Brief description/objective

A 52-year-old female was hospitalized with malaise, pruritus, jaundice, abdominal discomfort and vomiting. For 20 weeks she had been taking enalapril (Reniten) for hypertension. Serum aminotransferases and bilirubin were highly elevated with prolonged thromboplastin time. There was no evidence for extrahepatic cholestasis in ultrasonography. Serological investigations for a viral etiology of the liver failure were negative and the patient had no risk factors for viral hepatitis or exposure to hepatotoxic substances. Liver puncture revealed hepatitis of the fulminant viral hepatitis type, a picture that can be seen in a drug-induced hepatitis. The complete recovery of liver function after cessation of enalapril administration suggests acute toxic hepatitis due to enalapril. A metabolically mediated idiosyncratic reaction is the most plausible. Potential mechanisms of enalapril-induced hepatotoxicity are discussed and the current literature is surveyed.