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Metoprolol-induced Severe Liver Injury and Successful Management with Therapeutic Plasma Exchange

Liver injury caused by metoprolol is very rare with current reports limited to an isolated elevation in transaminases. We report the first case of severe icteric liver injury leading to hepatic encephalopathy secondary to metoprolol use in a patient diagnosed with coronary heart disease. We also des...

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Detalles Bibliográficos
Autores principales: Philips, Cyriac, Paramaguru, Rajaguru, Mahadevan, Pushpa, Ravindranath, Jayasurya, Augustine, Philip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453740/
https://www.ncbi.nlm.nih.gov/pubmed/28589058
http://dx.doi.org/10.7759/cureus.1209
Descripción
Sumario:Liver injury caused by metoprolol is very rare with current reports limited to an isolated elevation in transaminases. We report the first case of severe icteric liver injury leading to hepatic encephalopathy secondary to metoprolol use in a patient diagnosed with coronary heart disease. We also describe the histopathology of metoprolol-related liver injury, discuss mechanisms of injury with new insights on the immunological phenomenon, and shed light on the successful utility of early plasmapheresis as a salvage therapy in metoprolol-induced severe liver damage.