Gennaio Febbraio 2016 - Nefrologo in corsia

Clopidogrel- induced hepatotoxicity in hemodialyzed patient: a case report


Drug-induced liver injury is a frequent cause of acute liver failure. It may cause clinical manifestations ranging from simple alteration of the common liver function tests until more severe manifestations including encephalopathy, coagulopathy, and in many cases progressive multi-organ dysfunction. The condition, therefore, may be associated with higher morbidity and mortality as well as higher consumption of economic resources.

In this paper, we present the case of a 71-year-old patient treated with hemodialysis, diabetic, with ischemic cardiopathy and severe peripheral vascular disease. The patient presented a progressive clinical deterioration with the development of ascites, jaundice and significant deterioration of liver function.

Diagnostic studies have ruled out viral and immunological diseases and, in agreement with the score obtained from the Maria and Victorino scale, clopidogrel was identified as the major factor responsible for the damage.

After the suspension of the drug, the follow-up has led to the complete and stable recovery of liver function.

Key words: clopidogrel, dialysis, hepatotoxicity, ischemic cardiopathy

Full text of the article is available in Italian.