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Doxycycline: Rare but Real Cause of DILI (Drug-Induced Liver Injury)
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| Author:
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SHRAVAN KOORAGAYALU, MD,, FNU SREELAKSHMI, MD
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| Abstract:
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Drug-induced liver injury (DILI) is defined as an injury to the liver caused by a variety of medications, herbs and herbal products leading to abnormalities in liver tests after reasonable exclusion of other etiologies. Antibiotics, especially doxycycline is a less likely cause of hepatotoxicity. Here, we present an interesting case of idiosyncratic liver injury caused by Doxycycline. A 57-year old African American male presented to our hospital for an exacerbation of Chronic Obstructive Pulmonary Disease and was started on treatment with albuterol-ipratropium nebulization, Prednisone and Doxycycline. The following day, the patient started to complain of pain in the right upper quadrant and work up revealed deranged liver function tests, Right Upper Quadrant Ultrasound was normal. Doxycycline was suspected to be the cause of transaminitis. Other etiologies for liver injury were considered and excluded. Doxycycline was stopped and replaced with azithromycin. The patient's symptoms and the liver function abnormalities improved and were back to baseline in one week. This was a unique observation of doxycycline causing a mixed pattern of liver injury. We suggest clinicians have a high index of suspicion to avoid untoward consequences of drug-induced reactions.
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| Keyword:
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Drug-Induced Liver Injury, Immuno-allergic, Hepatocellular, Cholestatic, Roussel-Uclaf Causality Assessment Method (RUCAM) score.
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2020.SP1.053
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| Download:
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