Poster Presentations
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ABSTRACTS
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Poster Presentations P.109 Acute Hepatitis Induced by Rosuvastatin A. Oteri,1 L. Giacci,2 M.A. Catania,1 G. Polimeni,1,3 A. Russo,1 A.P. Caputi1,3 1 Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy; 2 Italian College of General Practitioners, Chieti, Italy; 3 IRCSS “Centro Neurolesi Bonino-Pulejo”, Messina, Italy A 62-year-old Caucasian man with a history of myocardial infarction was being treated with repaglinide, insulin, magnesium/aspirin and ramipril/hydrochlorothiazide for several years because of type II diabetes and hypertension. In January 2007, he was prescribed rosuvastatin 10 mg/ day for hypercholesterolemia; two months later, he was admitted to the emergency department with a diagnosis of acute hepatitis. His aspartate aminotransferase (AST) and alanine aminotransferase (ALT) serum levels were 1430 U/L (normal range 15-45 U/L) and 2317 U/ L (normal range 10-70 U/L) respectively. Total bilirubin and direct bilirubin were also elevated, with serum levels of 6.12 mg/dL (normal range 1-2 mg/dL) and 4.99 mg/dL (normal range 0.9-2 mg/dL), respectively. The patient had no previous history of alcohol abuse and did not take herbal remedies or illicit drugs. He was discharged after being symptomatically treated and was advised to withdraw rosuvastatin. AST and ALT serum levels gradually decreased to normal values within two weeks, thus suggesting a potential drug involvement. Adverse liver reactions are known effects of statins. However, compared to other statins, rosuvastatin is more selectively and efficiently taken up by hepatocytes, and this may reasonably represent an important variable to explain the hepatotoxic potential of the drug. According to the Naranjo adverse drug reaction probability scale, the likelihood that acute hepatitis was secondary to the assumption of rosuvastatin was probable. This case supports the finding that a clinically significant risk of liver toxicity should be considered even when rosuvastatin is given at the range of doses used in common clinical practice.
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