Autoimmune hepatitis can be triggered by statins

This paper was published in the Journal of Clinical Gastroenterology 2006 Sep;40(8):757-61

 

Study title and authors:

Autoimmune hepatitis triggered by statins.

Alla V, Abraham J, Siddiqui J, Raina D, Wu GY, Chalasani NP, Bonkovsky HL.

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16940892

This paper describes three patients in whom it is probable that statins initiated the development of autoimmune hepatitis. (Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them).

(i) Two men (aged 47 and 51) and one woman (aged 57) developed autoimmune hepatitis after the initiation of statin therapy.
(ii) The woman developed hepatitis due to statins on two separate occasions: the first in 1999, due to simvastatin, and the second in 2001 to 2002, due to atorvastatin, which was severe and persisted even after discontinuing medication.
(iii) In the two men, exposure to statins preceded development of autoimmune hepatitis, which persisted despite discontinuing medications.
(iv) Three similar previously reported cases were noted.

The researchers concluded that the three cases reported here and three similar previously reported cases, indicate that severe, ongoing autoimmune hepatitis can be triggered by statins.

Statins are a potential cause of cholestatic hepatitis

This paper was published in the American Journal of Gastroenterology 1999 May;94(5):1388-90

Study title and authors:
Acute cholestatic hepatitis associated with pravastatin.

Hartleb M, Rymarczyk G, Januszewski K.
Department of Gastroenterology, Silesian Medical School, Katowice, Poland.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/10235223

This paper describes a 57 year old man with acute cholestatic hepatitis. (Acute cholestatic hepatitis is where the bile ducts of the liver become obstructed by inflammation and may lead to jaundice).

The report found:
The man's symptoms had appeared 7 weeks after he was started on pravastatin 20 mg/day for "high cholesterol".

Investigations revealed a diagnosis of intrahepatic nonobstructive jaundice.

The liver function abnormalities normalized 7 weeks after cessation of therapy.

This paper shows that statins should be considered as a potential cause of cholestatic hepatitis.

Acute hepatitis induced by lovastatin

This study was published in Digestive Diseases and Sciences 1994 Sep;39(9):2032-3

Study title and authors:
Acute hepatitis induced by HMG-CoA reductase inhibitor, lovastatin.

Grimbert S, Pessayre D, Degott C, Benhamou JP.
Service d'Hépatologie, Unité de Recherches de Physiopathologie Hépatique (INSERM U 24), Hôpital Beaujon, Clichy, France.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8082513

This paper reports the case of an adult who suffered from clinical hepatitis three months after the onset of lovastatin administration.

The patient suffered:
(i) Loss of strength and energy.
(ii) Jaundice.
(iii) Increased aminotransferase levels. (Elevated levels of aminotransferase (an enzyme) suggest the existence of medical problems such as viral hepatitis, diabetes, congestive heart failure, liver damage and bile duct problems).
(iv) Increased alkaline phosphatase levels. (Elevated levels of alkaline phosphatase (an enzyme) indicate the presence of liver disease or bone disorders).

Examination of the patients liver cells revealed:
(a) Cell death.
(b) Blocked bile ducts.
(c) Increased white blood cell levels. (Elevated white blood cells in the liver, suggest the existence of liver damage).

Withdrawal of lovastatin was followed by complete normalization of liver tests within two months.

This report shows that statins may induce hepatitis.