Lorazepam causing drug-induced liver injury : Rare entity
Introduction Lorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia. Objectives The objective of our work was to show that Lorazepam can be a cause of unexpected liver injury even though it is a rare entity. Methods We reported the case of a pati...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821020460/type/journal_article |
| _version_ | 1797616412066316288 |
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| author | S. Sellami H. Mami M. Moalla M. Oumaya R. Bouzid |
| author_facet | S. Sellami H. Mami M. Moalla M. Oumaya R. Bouzid |
| author_sort | S. Sellami |
| collection | DOAJ |
| description |
Introduction
Lorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia.
Objectives
The objective of our work was to show that Lorazepam can be a cause of unexpected liver injury even though it is a rare entity.
Methods
We reported the case of a patient who had a Drug-Induced Liver Injury (DILI) under Lorazepam. We performed a literature review based on a PubMed search with the following keywords: “Lorazepam,DILI”.
Results
A 20 year-old-Tunisian woman was hospitalized in the psychiatry department of the hospital of Nabeul in Tunisia for a brief psychotic episode.She had a DILI under Olanzapine, Chlorpromazine and Lorazepam, which conducted us to interrupt her treatments except for the Lorazepam(5mg/day). The hepatic tests went back to normal even under Lorazepam. Few days later, the liver enzymes increased again to reach very high levels. Extensive workup was negative for other causes of liver injury, including viral hepatitis A, B, C and E.; capillary electrophoresis of serum proteins was normal; Exhaustive immunological tests were performed searching for auto immune hepatitis(anti-smooth muscle antibodies, anti-LKM1, anti-LC1, anti-SLA/LP) primary biliary cholangitis(anti-mitochondrial antibodies, anti-GP210, anti-sp100) and other antibodies like antinuclear antibodies were negative. Liver biopsy showed polymorphic inflammatory infiltrate including some eosinophilic polynuclear cells and rare vaguely epitheloid macrophages, with necrotico-inflammatory foci in the lobules, all of which were consistent with DILI. Lorazepam was discontinued and within 10 days her liver enzymes decreased and completely normalized.
Conclusions
Lorazepam, with an unknown action mechanism, can be a cause of DILI.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:39:40Z |
| format | Article |
| id | doaj.art-00a8759a7266406b87c28de9d26a86ef |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:39:40Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-00a8759a7266406b87c28de9d26a86ef2023-11-17T05:08:38ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S773S77410.1192/j.eurpsy.2021.2046Lorazepam causing drug-induced liver injury : Rare entityS. Sellami0H. Mami1M. Moalla2M. Oumaya3R. Bouzid4Department Of Psychiatry, University hospital of Nabeul, Nabeul, TunisiaDepartment Of Psychiatry, University hospital of Nabeul, Nabeul, TunisiaDepartment Of Gastroenterology, University hospital of Nabeul, Nabeul, TunisiaDepartment Of Psychiatry, University hospital of Nabeul, Nabeul, TunisiaDepartment Of Psychiatry, University hospital of Nabeul, Nabeul, Tunisia Introduction Lorazepam is a benzodiazepine derivative that is globally used for the therapy of anxiety and insomnia. Objectives The objective of our work was to show that Lorazepam can be a cause of unexpected liver injury even though it is a rare entity. Methods We reported the case of a patient who had a Drug-Induced Liver Injury (DILI) under Lorazepam. We performed a literature review based on a PubMed search with the following keywords: “Lorazepam,DILI”. Results A 20 year-old-Tunisian woman was hospitalized in the psychiatry department of the hospital of Nabeul in Tunisia for a brief psychotic episode.She had a DILI under Olanzapine, Chlorpromazine and Lorazepam, which conducted us to interrupt her treatments except for the Lorazepam(5mg/day). The hepatic tests went back to normal even under Lorazepam. Few days later, the liver enzymes increased again to reach very high levels. Extensive workup was negative for other causes of liver injury, including viral hepatitis A, B, C and E.; capillary electrophoresis of serum proteins was normal; Exhaustive immunological tests were performed searching for auto immune hepatitis(anti-smooth muscle antibodies, anti-LKM1, anti-LC1, anti-SLA/LP) primary biliary cholangitis(anti-mitochondrial antibodies, anti-GP210, anti-sp100) and other antibodies like antinuclear antibodies were negative. Liver biopsy showed polymorphic inflammatory infiltrate including some eosinophilic polynuclear cells and rare vaguely epitheloid macrophages, with necrotico-inflammatory foci in the lobules, all of which were consistent with DILI. Lorazepam was discontinued and within 10 days her liver enzymes decreased and completely normalized. Conclusions Lorazepam, with an unknown action mechanism, can be a cause of DILI. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933821020460/type/journal_articleLorazepamDILILiver Injurydrug |
| spellingShingle | S. Sellami H. Mami M. Moalla M. Oumaya R. Bouzid Lorazepam causing drug-induced liver injury : Rare entity European Psychiatry Lorazepam DILI Liver Injury drug |
| title | Lorazepam causing drug-induced liver injury : Rare entity |
| title_full | Lorazepam causing drug-induced liver injury : Rare entity |
| title_fullStr | Lorazepam causing drug-induced liver injury : Rare entity |
| title_full_unstemmed | Lorazepam causing drug-induced liver injury : Rare entity |
| title_short | Lorazepam causing drug-induced liver injury : Rare entity |
| title_sort | lorazepam causing drug induced liver injury rare entity |
| topic | Lorazepam DILI Liver Injury drug |
| url | https://www.cambridge.org/core/product/identifier/S0924933821020460/type/journal_article |
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