A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review
The incidence of drug-induced acute liver failure is increasing. A number of drugs can inhibit mitochondrial functions, alter β-oxidation and cause accumulation of free fatty acids within the hepatocytes. This may result in hepatic steatosis, cell death and liver injury. In our case, propofol, an an...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2010-02-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | http://www.karger.com/Article/FullText/262448 |
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| author | G. Kneiseler H.S. Bachmann L.P. Bechmann A. Dechene T. Heyer H. Baba F. Saner C. Jochum G. Gerken A. Canbay |
| author_facet | G. Kneiseler H.S. Bachmann L.P. Bechmann A. Dechene T. Heyer H. Baba F. Saner C. Jochum G. Gerken A. Canbay |
| author_sort | G. Kneiseler |
| collection | DOAJ |
| description | The incidence of drug-induced acute liver failure is increasing. A number of drugs can inhibit mitochondrial functions, alter β-oxidation and cause accumulation of free fatty acids within the hepatocytes. This may result in hepatic steatosis, cell death and liver injury. In our case, propofol, an anesthetic drug commonly used in adults and children, is suspected to have induced disturbance of the mitochondrial respiratory chain, which in consequence led to insufficient energy supply and finally liver failure. We report the case of a 35-year-old Caucasian woman with acute liver failure after anesthesia for stripping of varicose veins. Liver histology, imaging and laboratory data indicate drug-induced acute liver failure, presumably due to propofol. Hepatocyte death and microvesicular fatty degeneration of 90% of the liver parenchyma were observed before treatment with steroids. Six months later, a second biopsy was performed, which revealed only minimal steatosis and minimal periportal hepatitis. We suggest that propofol led to impaired fatty acid oxidation possibly due to a genetic susceptibility. This caused free fatty acid accumulation within hepatocytes, which presented as hepatocellular fatty degeneration and cell death. Large scale hepatocyte death was followed by impaired liver function and, consecutively, progressed to acute liver failure. |
| first_indexed | 2024-12-11T13:36:57Z |
| format | Article |
| id | doaj.art-172716b28c38471c9da55b93068d6e82 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-11T13:36:57Z |
| publishDate | 2010-02-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-172716b28c38471c9da55b93068d6e822022-12-22T01:04:59ZengKarger PublishersCase Reports in Gastroenterology1662-06312010-02-0141576510.1159/000262448262448A Rare Case of Propofol-Induced Acute Liver Failure and Literature ReviewG. KneiselerH.S. BachmannL.P. BechmannA. DecheneT. HeyerH. BabaF. SanerC. JochumG. GerkenA. CanbayThe incidence of drug-induced acute liver failure is increasing. A number of drugs can inhibit mitochondrial functions, alter β-oxidation and cause accumulation of free fatty acids within the hepatocytes. This may result in hepatic steatosis, cell death and liver injury. In our case, propofol, an anesthetic drug commonly used in adults and children, is suspected to have induced disturbance of the mitochondrial respiratory chain, which in consequence led to insufficient energy supply and finally liver failure. We report the case of a 35-year-old Caucasian woman with acute liver failure after anesthesia for stripping of varicose veins. Liver histology, imaging and laboratory data indicate drug-induced acute liver failure, presumably due to propofol. Hepatocyte death and microvesicular fatty degeneration of 90% of the liver parenchyma were observed before treatment with steroids. Six months later, a second biopsy was performed, which revealed only minimal steatosis and minimal periportal hepatitis. We suggest that propofol led to impaired fatty acid oxidation possibly due to a genetic susceptibility. This caused free fatty acid accumulation within hepatocytes, which presented as hepatocellular fatty degeneration and cell death. Large scale hepatocyte death was followed by impaired liver function and, consecutively, progressed to acute liver failure.http://www.karger.com/Article/FullText/262448Transient elastographyAcute liver failureDrug toxicityβ-OxidationFree fatty acids2,6-diisopropylphenol (propofol) |
| spellingShingle | G. Kneiseler H.S. Bachmann L.P. Bechmann A. Dechene T. Heyer H. Baba F. Saner C. Jochum G. Gerken A. Canbay A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review Case Reports in Gastroenterology Transient elastography Acute liver failure Drug toxicity β-Oxidation Free fatty acids 2,6-diisopropylphenol (propofol) |
| title | A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review |
| title_full | A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review |
| title_fullStr | A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review |
| title_full_unstemmed | A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review |
| title_short | A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review |
| title_sort | rare case of propofol induced acute liver failure and literature review |
| topic | Transient elastography Acute liver failure Drug toxicity β-Oxidation Free fatty acids 2,6-diisopropylphenol (propofol) |
| url | http://www.karger.com/Article/FullText/262448 |
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