Liver Transplantation for Metamizole induced Acute Liver Failure. 2022

Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Augustenburger Platz 1, 13353, Berlin, Germany.

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.

UI MeSH Term Description Entries
D004177 Dipyrone A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE. Metamizole,Methampyrone,Noramidopyrine Methanesulfonate,Algopyrin,Analgin,Biopyrin,Dipyronium,Metamizol,Metamizole Sodium,Methamizole,Narone,Noramidopyrine Methanesulfonate Sodium,Normelubrine,Novalgetol,Novalgin,Novamidazophen,Novaminsulfone,Optalgin,Pyralgin,Sulpyrin,Sulpyrine
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016031 Liver Transplantation The transference of a part of or an entire liver from one human or animal to another. Grafting, Liver,Hepatic Transplantation,Liver Transplant,Transplantation, Hepatic,Transplantation, Liver,Hepatic Transplantations,Liver Grafting,Liver Transplantations,Liver Transplants,Transplant, Liver
D017114 Liver Failure, Acute A form of rapid-onset LIVER FAILURE, also known as fulminant hepatic failure, caused by severe liver injury or massive loss of HEPATOCYTES. It is characterized by sudden development of liver dysfunction and JAUNDICE. Acute liver failure may progress to exhibit cerebral dysfunction even HEPATIC COMA depending on the etiology that includes hepatic ISCHEMIA, drug toxicity, malignant infiltration, and viral hepatitis such as post-transfusion HEPATITIS B and HEPATITIS C. Acute Hepatic Failure,Fulminant Hepatic Failure,Fulminating Hepatic Failure,Hepatic Failure, Fulminant,Liver Failure, Fulminant,Acute Liver Failure,Fulminating Liver Failure,Hepatic Failure, Acute,Failure, Acute Hepatic,Failure, Acute Liver,Fulminant Hepatic Failures,Fulminant Liver Failure,Fulminant Liver Failures,Fulminating Hepatic Failures,Fulminating Liver Failures,Hepatic Failure, Fulminating,Liver Failure, Fulminating
D056486 Chemical and Drug Induced Liver Injury A spectrum of clinical liver diseases ranging from mild biochemical abnormalities to ACUTE LIVER FAILURE, caused by drugs, drug metabolites, herbal and dietary supplements and chemicals from the environment. Drug-Induced Liver Injury,Liver Injury, Drug-Induced,Acute Liver Injury, Drug-Induced,Chemically-Induced Liver Toxicity,Drug-Induced Acute Liver Injury,Drug-Induced Liver Disease,Hepatitis, Drug-Induced,Hepatitis, Toxic,Liver Injury, Drug-Induced, Acute,Toxic Hepatitis,Acute Liver Injury, Drug Induced,Chemically Induced Liver Toxicity,Chemically-Induced Liver Toxicities,Disease, Drug-Induced Liver,Diseases, Drug-Induced Liver,Drug Induced Acute Liver Injury,Drug Induced Liver Disease,Drug Induced Liver Injury,Drug-Induced Hepatitides,Drug-Induced Hepatitis,Drug-Induced Liver Diseases,Drug-Induced Liver Injuries,Hepatitides, Drug-Induced,Hepatitides, Toxic,Hepatitis, Drug Induced,Injuries, Drug-Induced Liver,Injury, Drug-Induced Liver,Liver Disease, Drug-Induced,Liver Diseases, Drug-Induced,Liver Injuries, Drug-Induced,Liver Injury, Drug Induced,Liver Toxicities, Chemically-Induced,Liver Toxicity, Chemically-Induced,Toxic Hepatitides,Toxicities, Chemically-Induced Liver,Toxicity, Chemically-Induced Liver
D064420 Drug-Related Side Effects and Adverse Reactions Disorders that result from the intended use of PHARMACEUTICAL PREPARATIONS. Included in this heading are a broad variety of chemically-induced adverse conditions due to toxicity, DRUG INTERACTIONS, and metabolic effects of pharmaceuticals. Drug-Related Side Effects and Adverse Reaction,Adverse Drug Event,Adverse Drug Reaction,Drug Side Effects,Drug Toxicity,Side Effects of Drugs,Toxicity, Drug,Adverse Drug Events,Adverse Drug Reactions,Drug Event, Adverse,Drug Events, Adverse,Drug Reaction, Adverse,Drug Reactions, Adverse,Drug Related Side Effects and Adverse Reaction,Drug Related Side Effects and Adverse Reactions,Drug Side Effect,Drug Toxicities,Effects, Drug Side,Reactions, Adverse Drug,Side Effect, Drug,Side Effects, Drug,Toxicities, Drug

Related Publications

Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
July 2021, Clinics and research in hepatology and gastroenterology,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
November 2019, Harefuah,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
January 2024, Journal of clinical and experimental hepatology,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
March 2017, European review for medical and pharmacological sciences,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
January 2003, Digestive diseases and sciences,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
January 2019, Frontiers in pharmacology,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
September 2020, Deutsches Arzteblatt international,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
December 2022, Cureus,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
February 2012, Best practice & research. Clinical gastroenterology,
Julian Pohl, and Philip Bischoff, and Robert Oellinger, and Wenzel Schoening, and Georg Lurje, and Johann Pratschke, and David Horst, and Frank Tacke, and Alexander Wree
April 2017, Cirugia espanola,
Copied contents to your clipboard!