Acute cholestatic hepatitis induced by nimesulide

COX-2 inhibitor (nimesulide) induced acute liver failure

“…Moreover, it is also unclear how liver cell damage is caused by the drug. Based on the current literature it seems that nimesulide causes two characteristic histological patterns of hepatic injury: (a) centrilobular hepatocellular necrosis and (b) pure cholestasis resembling the pattern of ethinyl estradiol or androgen-induced cho- lestasis [1,4,5,7,8,9]. In our patient we observed extensive centrilobular necrosis and a mixed inflammatory infiltrate with numerous eosinophils.…”

“…It is 5-to 16-fold more selective for COX-2 than classical NSAIDS and seems to be associated with a lower risk of side effects [3,6]. However, recently several cases of severe liver injury have been reported after the administration of nimesulide [1,4,5,7,8,9]. We describe here the clinicopathological characteristics of a case of nimesulide-associated acute hepatic failure and discuss the current literature.…”

Hepatoprotective effects of Yulangsan polysaccharide against nimesulide-induced liver injury in mice

“…Nimesulide caused significant hepatic damage through unpredictable adverse reactions in the liver, including increases in serum aminotransferase activities, hepatocellular necrosis, and/or intrahepatic cholestasis (Dastis et al, 2007, Merlani et al, 2001, Romero-Gomez et al, 1999, Traversa et al, 2003. Liver injury is generally assessed with histological analyses and biochemical parameters, including AST, ALT, and ALP activities and bilirubin levels in the serum.…”

“…However, reports of acute liver injury associated with nimesulide are increasing (Wang et al, 2011, Romero-Gomez et al, 1999, Ong et al, 2006, Merlani et al, 2001. Nimesulide can cause significant hepatic damage, as evidenced by significant increases in serum aminotransferase (Wang et al, 2011, Leone et al, 2014.…”

Nimesulide-Induced Acute Hepatitis

“…3, 4 More serious toxicities in the form of acute hepatocellular necrosis or acute cholestatic hepatitis have been reported. 5, 6 We report a case of reversible acute hepatocellular necrosis due to nimesulide that was confirmed by biopsy and an in vitro laboratory assay.…”