Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia
Niacin, an important component of a balanced diet, is central to lipid metabolism. Occasionally used to treat hyperlipidemia, niacin is widely available without a prescription, making its use often unknown to treating physicians. Severe hepatotoxicity has been reported with niacin use. In the follow...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-01-01
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| Series: | Journal of Investigative Medicine High Impact Case Reports |
| Online Access: | https://doi.org/10.1177/23247096231224349 |
| _version_ | 1797359825356587008 |
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| author | Nanjiba Nawaz MD Tyler Mistretta MD Christian Karime MD Jason Lewis MD Emily Wolf MD |
| author_facet | Nanjiba Nawaz MD Tyler Mistretta MD Christian Karime MD Jason Lewis MD Emily Wolf MD |
| author_sort | Nanjiba Nawaz MD |
| collection | DOAJ |
| description | Niacin, an important component of a balanced diet, is central to lipid metabolism. Occasionally used to treat hyperlipidemia, niacin is widely available without a prescription, making its use often unknown to treating physicians. Severe hepatotoxicity has been reported with niacin use. In the following report, we describe a case of hospitalization for acute decompensated cirrhosis with cholestatic morphology in a patient taking self-initiated large quantities of extended-release niacin. Despite medical management and support, the patient unfortunately expired on day 16 of hospitalization. Given ease of access and unclear long-term benefit in hyperlipidemia, the current case serves to raise awareness of niacin’s potential hepatotoxicity through highlighting a severe outcome. Although mode of liver injury remains unknown, the use of extended-release niacin formulations and prolonged high-dose supplementation is associated with enhanced hepatotoxicity. Careful review and counseling of commonly available supplements remains an important task of both hospital and primary care physicians. |
| first_indexed | 2024-03-08T15:29:21Z |
| format | Article |
| id | doaj.art-4f9b58bee0d44a70828ea61290015be8 |
| institution | Directory Open Access Journal |
| issn | 2324-7096 |
| language | English |
| last_indexed | 2024-03-08T15:29:21Z |
| publishDate | 2024-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| spelling | doaj.art-4f9b58bee0d44a70828ea61290015be82024-01-10T07:04:14ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962024-01-011210.1177/23247096231224349Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for HyperlipidemiaNanjiba Nawaz MD0Tyler Mistretta MD1Christian Karime MD2Jason Lewis MD3Emily Wolf MD4Mayo Clinic, Jacksonville, FL, USAMayo Clinic, Jacksonville, FL, USAMayo Clinic, Jacksonville, FL, USAMayo Clinic, Jacksonville, FL, USAMayo Clinic, Jacksonville, FL, USANiacin, an important component of a balanced diet, is central to lipid metabolism. Occasionally used to treat hyperlipidemia, niacin is widely available without a prescription, making its use often unknown to treating physicians. Severe hepatotoxicity has been reported with niacin use. In the following report, we describe a case of hospitalization for acute decompensated cirrhosis with cholestatic morphology in a patient taking self-initiated large quantities of extended-release niacin. Despite medical management and support, the patient unfortunately expired on day 16 of hospitalization. Given ease of access and unclear long-term benefit in hyperlipidemia, the current case serves to raise awareness of niacin’s potential hepatotoxicity through highlighting a severe outcome. Although mode of liver injury remains unknown, the use of extended-release niacin formulations and prolonged high-dose supplementation is associated with enhanced hepatotoxicity. Careful review and counseling of commonly available supplements remains an important task of both hospital and primary care physicians.https://doi.org/10.1177/23247096231224349 |
| spellingShingle | Nanjiba Nawaz MD Tyler Mistretta MD Christian Karime MD Jason Lewis MD Emily Wolf MD Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia Journal of Investigative Medicine High Impact Case Reports |
| title | Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia |
| title_full | Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia |
| title_fullStr | Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia |
| title_full_unstemmed | Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia |
| title_short | Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia |
| title_sort | cholestatic drug induced liver injury in a patient taking high dose niacin for hyperlipidemia |
| url | https://doi.org/10.1177/23247096231224349 |
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