Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review

Patti, Ravikaran; Sinha, Ankur; Sharma, Shaurya; Yoon, Taek; Kupfer, Yizhak

doi:10.7759/cureus.4769

Cited by 3 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with existing liver conditions should be informed of the risks and advised on the potential need for immediate drug discontinuation and clinical follow-up to prevent severe hepatic damage. The incidence of DILI with losartan as the offending agent is relatively low in the general population (Table 2 ) [ 4 - 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, losartan-induced hepatotoxicity, an exceedingly rare adverse effect with high morbidity and mortality, is not widely reported in the literature. Only a few cases have been reported, providing an association between losartan and acute hepatic injury [ 4 ]. We report a case of severe hepatic injury attributed to losartan use in a 54-year-old male patient with underlying hypertension.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Marked Hepatotoxicity Associated With Losartan Treatment: A Case Report

Zahedi,

Sami,

Ijishakin

et al. 2023

Cureus

View full text Add to dashboard Cite

Losartan is a widely prescribed angiotensin II receptor blocker (ARB) used for the management of hypertension and various cardiovascular conditions. While it is generally considered a safe medication, rare cases of hepatotoxicity have been reported in the literature. We present a case of severe hepatic injury and sub-fulminant hepatitis attributed to losartan use in a 54-year-old male patient with underlying hypertension. He presented with a two-week history of abdominal pain, progressive jaundice, dark urine, and vomiting, followed by altered sensorium. His clinical picture, serology, and imaging findings confirmed a severe hepatic injury. After ruling out all possible causes, he was diagnosed with drug-induced hepatotoxicity with losartan treatment. He started improving gradually after losartan discontinuation, N-acetylcysteine administration, and supportive management with close monitoring of liver enzymes. This case report aims to underscore the importance of recognizing losartan as one of the potential causes of hepatotoxicity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Marked Hepatotoxicity Associated With Losartan Treatment: A Case Report

Zahedi,

Sami,

Ijishakin

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…The hepatic lesion is mainly hepatocellular, although, less frequently, cholestasis or mixed patterns have also been described. There are 19 reported cases of toxic hepatitis due to ARA-II, of which only seven are related to losartan [ 3 ] . This is the eighth case of severe toxic hepatitis associated with losartan, with hepatocellular presentation and elevation of transaminases about 10 times above the upper limit.…”

Section: Discussionmentioning

confidence: 99%

“…This is the eighth case of severe toxic hepatitis associated with losartan, with hepatocellular presentation and elevation of transaminases about 10 times above the upper limit. In two of the previous cases, transaminases were elevated around 75–100 times the upper limit of normal [ 3 ] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Drug-Induced Liver Injury Due To Losartan

Diogo

Monteiro

Coelho

et al. 2021

European Journal of Case Reports in Internal Medicine

View full text Add to dashboard Cite

Drug-induced liver injury (DILI) is a challenging diagnosis since a wide variety of medicines can cause adverse reactions. Losartan is an angiotensin II receptor antagonist (ARA-II) approved for the treatment of arterial hypertension. The most common adverse effects are fatigue, anaemia, weakness and cough. An increase in transaminases has been reported with less frequency (<2% of cases). Although the mechanism is not fully understood, DILI onset is usually within 1–8 weeks of therapy, and hepatic enzymology usually normalizes 2–4 months after drug suspension. The authors present the case of a 66-year-old male patient with a medical history of arterial hypertension and a prior hospitalization (4 years previously) for drug-induced hepatitis, which, at the time, was attributed to a dietary supplement. Four years later, because of new onset of hypertension, losartan was reintroduced. After 3 weeks, the patient was admitted to the emergency department with complaints of acute abdominal pain associated with asthenia, nausea and increased abdominal volume that had first developed 8 days previously. After exclusion of other causes, DILI associated with losartan was assumed. This is a very rare adverse effect since only seven cases have been described in the literature.

show abstract

Losartan Alleviates the Side Effects and Maintains the Anticancer Activity of Axitinib

Saxu

Ridwan

et al. 2022

Molecules

View full text Add to dashboard Cite

Axitinib is one of the most potent inhibitors of the vascular endothelial growth factor (VEGF) receptor and shows strong antitumor activity toward various malignant tumors. However, its severe side effects affect the quality of life and prognosis of patients. Losartan, which functions as a typical angiotensin receptor blocker, controls the average arterial pressure of patients with essential hypertension and protects against hypertension-related secondary diseases, including proteinuria and cardiovascular injury. To explore the effects of losartan on side effects caused by axitinib and its antitumor activity, several animal experiments were conducted. This study first analyzed and explored the effect of losartan on the amelioration of side effects in Wistar rats caused by axitinib. The results showed that the systolic blood pressure of Wistar rats was significantly increased by about 30 mmHg in 7 days of axitinib treatment, while the combination of losartan significantly reduced the blood pressure rise caused by axitinib. The Miles experimental model and mouse xenograft tumor model were further used to evaluate the effect of losartan on the antitumor effect of axitinib. The result clearly demonstrated that losartan has no significant influence on axitinib-related low vascular permeability and antitumor activity. In summary, our results showed that the combination of axitinib and losartan significantly reduced the side effects and maintained the antitumor effects of axitinib. This study provides information for overcoming VEGF receptor inhibitor-related side effects.

show abstract

Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review

Cited by 3 publications

References 10 publications

Marked Hepatotoxicity Associated With Losartan Treatment: A Case Report

Marked Hepatotoxicity Associated With Losartan Treatment: A Case Report

Drug-Induced Liver Injury Due To Losartan

Losartan Alleviates the Side Effects and Maintains the Anticancer Activity of Axitinib

Contact Info

Product

Resources

About