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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Main Authors: Preethi Dileep Menon, Tamneet Singh, Hopethe Hubbard, Sarah Hackman, Francis E. Sharkey
Format: Article
Language:English
Published: Wiley 2020-01-01
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.
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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
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AT hopethehubbard cholangiolyticchangesinstatininducedliverinjury
AT sarahhackman cholangiolyticchangesinstatininducedliverinjury
AT francisesharkey cholangiolyticchangesinstatininducedliverinjury