Is Acute Hepatocellular Injury By Statins, A Class Effect?

ABSTRACTHepatotoxicity is one of the primary causes of Acute liver failure. It is rarely encountered because of its low incidence and lack of research. Pharmaceutical preparations are currently serious contributors to hepatotoxicity. Susceptibility factors that predispose the individuals to drug induced liver injury have not been identified. An unabridged instrument should be made for evaluation of drug induced hepatotoxicity. We present a case report of a 49 year old male, a case of unstable angina who developed signs of idiosyncratic hepatocellular injury in response to Atorvastatin 80mg. His liver enzymes had strikingly elevated, which resolved on withdrawal of the drug. No other concomitant drugs taken by the patient could attribute to this phenomenon. The patient was then prescribed with Rosuvastatin 10mg per day for cardiovascular risk reduction after a temporary statin free period. This demonstrated a lack of class effect on statin induced hepatotoxicity. Although many case reports are available on statin induced transaminitis, this case report stands out due to the presence of clinically significant symptoms of Acute hepatocellular  injury, strikingly elevated liver enzymes and positive outcome with a switch over to another statin. Keywords: Hepatotoxicity, Atorvastatin, Acute liver failure