Ibuprofen
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Liver failure, acute renal failure and nephrotic syndrome: case report A 43-year-old man with chronic back pain developed liver and acute renal failure with nephrotic syndrome during treatment with ibuprofen [route and duration of treatment to reaction onset not stated]. The man, who had been receiving ibuprofen 400mg every 8 hours, was hospitalised with a 10-day history of fatigue and jaundice. On examination, he exhibited jaundice, ascites, hepatomegaly and pedal oedema. Laboratory investigations revealed the following: ALT 89 IU/L, AST 190 IU/L, ALP 532 IU/L, GGT 300 U/L, total bilirubin 5.2 mg/dL, albumin 1.5 mg/dL, BUN 106 mg/dL, creatinine 7.5 mg/dL and nephrotic range proteinuria. His metabolic panel had been normal 3 months earlier. Granulomatous hepatitis, likely attributable to druginduced liver injury, was evident on liver biopsy, and minimal change disease and severe acute tubular necrosis likely attributable to NSAID use, were noted on renal biopsy. Ibuprofen was discontinued. The man’s clinical condition and blood values improved over the following 2 weeks, and he was discharged. Author comment: "Our case is the first case which illustrates hepatic failure with granulomatous hepatitis, which occurred concurrently with acute renal failure and nephrotic syndrome associated with Ibuprofen." Nabh A, et al. Liver Failure Associated with Ibuprofen. 76th Annual Scientific Meeting of the American College of Gastroenterology : abstr. P612, 28 Oct 2011. Available from: URL: http://download.abstractcentral.com/ACG2011/proofs/ 803065767 P612.html [abstract] - USA
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Reactions 21 Jan 2012 No. 1385
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