Cholangiolytic Changes in Statin-Induced Liver Injury
Atorvastatin is a commonly used oral cholesterol-lowering agent. Side effects associated with statin therapy include arthralgia, myalgia, dyspepsia, weakness, and headache. Prospective and retrospective studies of drug-induced liver injury have identified statin-induced hepatotoxicity, with atorvast...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Pathology |
| Online Access: | http://dx.doi.org/10.1155/2020/9650619 |
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| author | Preethi Dileep Menon Tamneet Singh Hopethe Hubbard Sarah Hackman Francis E. Sharkey |
| author_facet | Preethi Dileep Menon Tamneet Singh Hopethe Hubbard Sarah Hackman Francis E. Sharkey |
| author_sort | Preethi Dileep Menon |
| collection | DOAJ |
| description | Atorvastatin is a commonly used oral cholesterol-lowering agent. Side effects associated with statin therapy include arthralgia, myalgia, dyspepsia, weakness, and headache. Prospective and retrospective studies of drug-induced liver injury have identified statin-induced hepatotoxicity, with atorvastatin being the most commonly cited. Associated liver function test elevations have varied from hepatocellular to cholestatic/mixed pattern. We report a case of a 58-year-old woman that illustrates unusual histologic findings associated with a mixed pattern of statin-induced liver injury. While being treated with atorvastatin, the patient exhibited repeated bouts of abdominal pain over a year associated with biliary tree dilation, variably attributed to postcholecystectomy dilation and stenosis of the ampulla of Vater. Following sphincterotomy, the patient’s bilirubin normalized but the other liver function tests remained elevated. Liver biopsy revealed portal and lobular inflammation with cholangiolysis. The patient’s liver function tests normalized following cessation of atorvastatin therapy. |
| format | Article |
| id | doaj-art-ea124d38792b4e188d7d68c67d623654 |
| institution | OA Journals |
| issn | 2090-6781 2090-679X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pathology |
| spelling | doaj-art-ea124d38792b4e188d7d68c67d6236542025-08-20T02:21:46ZengWileyCase Reports in Pathology2090-67812090-679X2020-01-01202010.1155/2020/96506199650619Cholangiolytic Changes in Statin-Induced Liver InjuryPreethi Dileep Menon0Tamneet Singh1Hopethe Hubbard2Sarah Hackman3Francis E. Sharkey4Department of Pathology and Laboratory Medicine, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229-3900, USADivision of Gastroenterology and Nutrition, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229, USADivision of Gastroenterology and Nutrition, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229, USADepartment of Pathology and Laboratory Medicine, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229-3900, USADepartment of Pathology and Laboratory Medicine, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas 78229-3900, USAAtorvastatin is a commonly used oral cholesterol-lowering agent. Side effects associated with statin therapy include arthralgia, myalgia, dyspepsia, weakness, and headache. Prospective and retrospective studies of drug-induced liver injury have identified statin-induced hepatotoxicity, with atorvastatin being the most commonly cited. Associated liver function test elevations have varied from hepatocellular to cholestatic/mixed pattern. We report a case of a 58-year-old woman that illustrates unusual histologic findings associated with a mixed pattern of statin-induced liver injury. While being treated with atorvastatin, the patient exhibited repeated bouts of abdominal pain over a year associated with biliary tree dilation, variably attributed to postcholecystectomy dilation and stenosis of the ampulla of Vater. Following sphincterotomy, the patient’s bilirubin normalized but the other liver function tests remained elevated. Liver biopsy revealed portal and lobular inflammation with cholangiolysis. The patient’s liver function tests normalized following cessation of atorvastatin therapy.http://dx.doi.org/10.1155/2020/9650619 |
| spellingShingle | Preethi Dileep Menon Tamneet Singh Hopethe Hubbard Sarah Hackman Francis E. Sharkey Cholangiolytic Changes in Statin-Induced Liver Injury Case Reports in Pathology |
| title | Cholangiolytic Changes in Statin-Induced Liver Injury |
| title_full | Cholangiolytic Changes in Statin-Induced Liver Injury |
| title_fullStr | Cholangiolytic Changes in Statin-Induced Liver Injury |
| title_full_unstemmed | Cholangiolytic Changes in Statin-Induced Liver Injury |
| title_short | Cholangiolytic Changes in Statin-Induced Liver Injury |
| title_sort | cholangiolytic changes in statin induced liver injury |
| url | http://dx.doi.org/10.1155/2020/9650619 |
| work_keys_str_mv | AT preethidileepmenon cholangiolyticchangesinstatininducedliverinjury AT tamneetsingh cholangiolyticchangesinstatininducedliverinjury AT hopethehubbard cholangiolyticchangesinstatininducedliverinjury AT sarahhackman cholangiolyticchangesinstatininducedliverinjury AT francisesharkey cholangiolyticchangesinstatininducedliverinjury |