Patient with drug-induced hepatic injury caused by long-term administration of an Angiotesin II receptor antagonist, Losartan

Abstract

A woman in her fifties who had been receiving losartan for six years was admitted to our hospital with suspected dermatomyositis and acute liver injury. Laboratory data revealed marked elevation of both aspartate aminotransferase and alanine aminotransferase. The drug-lymphocyte stimulation test for losartan was positive. Liver biopsy showed moderate fat deposition in the hepatocytes, apoptosis, portal inflammation, and infiltration with lymphocytes and eosinophils. After cessation of losartan administration, the liver injury gradually and slowly recovered. According to the diagnostic scale proposed at the Digestive Disease Week-Japan 2004, her liver injury was classified with a high possibility as hepatocellular injury type. Taken together, the liver injury was diagnosed as losartan-induced hepatic injury. Herein, we report a case of drug induced liver injury after long-term administration of losartan, and review the literature for similar cases. Key words: drug-induced liver injury (DILI) injury angiotesin II receptor antagonist losartan drug-lymphocyte stimulation test (DLST) dermatomyositis. © 2013 The Japan Society of Hepatology.