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Liver injury in an elderly patient: case report An 88-year-old woman developed liver injury while receiving pravastatin and adjuvant hormonal therapy with anastrozole for breast cancer [routes and durations of treatment to reaction onset not stated]. The woman, who had a history of hypertension, hyperlipidaemia, coronary artery disease, and a mastectomy 5 years earlier, was admitted with major depression. Her medications included anastrozole daily [dose not stated], pravastatin [dosage and indication not stated], aspirin, metoprolol, enalapril, clopidogrel and alendronic acid. Laboratory analysis revealed abnormal liver function test results, with total bilirubin, ALT, AST, GGT and alkaline phosphatase levels of 1.3 mg/dL, 167 IU/L, 159 IU/L, 1578 IU/L and 509 IU/L, respectively. A review of her records revealed that her liver function test results had been normal 2 months prior to admission. The woman received mirtazapine for her mood disorder, and anastrozole was withdrawn. Her liver function test results improved, and she was advised to follow-up with her oncologist for alternative treatment. Author comment: "[A]nastrozole and pravastatin were likely causes for [drug induced liver injury]." Juhasz J, et al. A Case of Drug Induced Liver Injury. 76th Annual Scientific Meeting of the American College of Gastroenterology : abstr. P1037, 28 Oct 2011. Available from: URL: http://download.abstractcentral.com/ACG2011/proofs/ 803065803 P1037.html - Grenada

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Reactions 21 Jan 2012 No. 1385