Diphenhydramine as a Cause of Drug-Induced Liver Injury
Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the Unites States and accounts for 10% of acute hepatitis cases. We report the only known case of diphenhydramine-induced acute liver injury in the absence of concomitant medications. A 28-year-old man with history o...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2017/3864236 |
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| author | Yunseok Namn Yecheskel Schneider Isabelle H. Cui Arun Jesudian |
| author_facet | Yunseok Namn Yecheskel Schneider Isabelle H. Cui Arun Jesudian |
| author_sort | Yunseok Namn |
| collection | DOAJ |
| description | Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the Unites States and accounts for 10% of acute hepatitis cases. We report the only known case of diphenhydramine-induced acute liver injury in the absence of concomitant medications. A 28-year-old man with history of 13/14-chromosomal translocation presented with fevers, vomiting, and jaundice. Aspartate-aminotransferase and alanine-aminotransferase levels peaked above 20,000 IU/L and 5,000 IU/L, respectively. He developed coagulopathy but without altered mental status. Patient reported taking up to 400 mg diphenhydramine nightly, without concomitant acetaminophen, for insomnia. He denied taking other medications, supplements, antibiotics, and herbals. A thorough workup of liver injury ruled out viral hepatitis (including A, B, C, and E), autoimmune, toxic, ischemic, and metabolic etiologies including Wilson’s disease. A liver biopsy was consistent with DILI without evidence of iron or copper deposition. Diphenhydramine was determined to be the likely culprit. This is the first reported case of diphenhydramine-induced liver injury without concomitant use of acetaminophen. |
| format | Article |
| id | doaj-art-8ff71d514c48406cb4089ac5ba1888d5 |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-8ff71d514c48406cb4089ac5ba1888d52025-02-03T01:32:52ZengWileyCase Reports in Hepatology2090-65872090-65952017-01-01201710.1155/2017/38642363864236Diphenhydramine as a Cause of Drug-Induced Liver InjuryYunseok Namn0Yecheskel Schneider1Isabelle H. Cui2Arun Jesudian3Department of Gastroenterology and Hepatology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USADepartment of Gastroenterology and Hepatology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USADepartment of Pathology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USADepartment of Gastroenterology and Hepatology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USADrug-induced liver injury (DILI) is the most common cause of acute liver failure in the Unites States and accounts for 10% of acute hepatitis cases. We report the only known case of diphenhydramine-induced acute liver injury in the absence of concomitant medications. A 28-year-old man with history of 13/14-chromosomal translocation presented with fevers, vomiting, and jaundice. Aspartate-aminotransferase and alanine-aminotransferase levels peaked above 20,000 IU/L and 5,000 IU/L, respectively. He developed coagulopathy but without altered mental status. Patient reported taking up to 400 mg diphenhydramine nightly, without concomitant acetaminophen, for insomnia. He denied taking other medications, supplements, antibiotics, and herbals. A thorough workup of liver injury ruled out viral hepatitis (including A, B, C, and E), autoimmune, toxic, ischemic, and metabolic etiologies including Wilson’s disease. A liver biopsy was consistent with DILI without evidence of iron or copper deposition. Diphenhydramine was determined to be the likely culprit. This is the first reported case of diphenhydramine-induced liver injury without concomitant use of acetaminophen.http://dx.doi.org/10.1155/2017/3864236 |
| spellingShingle | Yunseok Namn Yecheskel Schneider Isabelle H. Cui Arun Jesudian Diphenhydramine as a Cause of Drug-Induced Liver Injury Case Reports in Hepatology |
| title | Diphenhydramine as a Cause of Drug-Induced Liver Injury |
| title_full | Diphenhydramine as a Cause of Drug-Induced Liver Injury |
| title_fullStr | Diphenhydramine as a Cause of Drug-Induced Liver Injury |
| title_full_unstemmed | Diphenhydramine as a Cause of Drug-Induced Liver Injury |
| title_short | Diphenhydramine as a Cause of Drug-Induced Liver Injury |
| title_sort | diphenhydramine as a cause of drug induced liver injury |
| url | http://dx.doi.org/10.1155/2017/3864236 |
| work_keys_str_mv | AT yunseoknamn diphenhydramineasacauseofdruginducedliverinjury AT yecheskelschneider diphenhydramineasacauseofdruginducedliverinjury AT isabellehcui diphenhydramineasacauseofdruginducedliverinjury AT arunjesudian diphenhydramineasacauseofdruginducedliverinjury |