Niacin‐Induced Anicteric Microvesicular Steatotic Acute Liver Failure

Niacin (vitamin B3) is available as a prescription medication and over‐the‐counter supplement. Although it is well known for its vasodilatory effect, it has also been associated with mild hepatotoxicity and, rarely, acute liver failure. We present the case of a 74‐year‐old Hispanic woman who develop...

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Bibliographic Details
Main Authors: Kenneth Leung, Michael Quezada, Zhengshan Chen, Gary Kanel, Neil Kaplowitz
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2018-11-01
Series:Hepatology Communications
Online Access:https://doi.org/10.1002/hep4.1253
Description
Summary:Niacin (vitamin B3) is available as a prescription medication and over‐the‐counter supplement. Although it is well known for its vasodilatory effect, it has also been associated with mild hepatotoxicity and, rarely, acute liver failure. We present the case of a 74‐year‐old Hispanic woman who developed acute liver failure (anicteric encephalopathy and coagulopathy) after her home dose of immediate‐release niacin was replaced with an extended‐release formulation during an inpatient hospital stay. This is the first reported case of niacin toxicity associated with a histopathologic finding of diffuse microvesicular steatosis. This unique phenotype strongly implicates mitochondrial impairment as a mechanism of niacin‐induced hepatotoxicity.
ISSN:2471-254X