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Liver Transplantation for Metamizole induced Acute Liver Failure. | LitMetric

Liver Transplantation for Metamizole induced Acute Liver Failure.

Transplant Proc

Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address:

Published: September 2022

AI Article Synopsis

  • Metamizole (dipyrone) is a commonly used painkiller that can lead to drug-induced liver injury (DILI), with only 61 reported cases of this adverse effect, including the study in question.
  • The German Federal Institute highlighted DILI as a possible risk associated with metamizole after a larger study identified more cases, raising awareness of this issue.
  • The report details two patients who developed acute liver failure after using metamizole, both requiring emergency liver transplants, emphasizing the need to consider metamizole as a potential cause in unexplained cases of liver failure.

Article Abstract

Metamizole, or dipyrone, is a frequently prescribed analgetic drug that can cause drug-induced liver injury (DILI). Still, there are only a few metamizole-associated DILI cases (n = 61, including our study) described in the literature. So far liver transplantation has been reported in 6 patients with metamizole-induced acute liver failure. In 2020, a German group described a bigger cohort (n = 23) of metamizole-related DILI. Shortly thereafter, this issue gained wider attention as the German Federal Institute for Drugs and Medical Devices published a Direct Healthcare Professional Communication, emphasizing DILI as a potential adverse event caused by metamizole. We herein report 2 patients that were admitted to our liver transplant center due to acute liver failure (ALF) in April and May 2021. Both patients reported intake of metamizole as pain medication over a few weeks. After ruling out alternative reasons for ALF and fulfilling the King's College criteria both patients received emergency liver transplantations in our center. Pathology assessment of both explants were consistent with metamizole-associated DILI. As illustrated by our 2 cases of metamizole-induced liver failure with subsequent liver transplantation, this rare but presumably often overlooked adverse drug effect of metamizole should be considered as differential diagnosis in cases of cryptogenic liver failure.

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Source
http://dx.doi.org/10.1016/j.transproceed.2022.04.028DOI Listing

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