Biomaterial Database

Nicotinic acid-induced fulminant hepatic failure. 1987

G L Clementz, and A W Holmes

Department of Family Practice, University of Illinois College of Medicine at Peoria 61656.

A 46-year-old man began taking nicotinic acid, 3 g daily, for hypercholesterolemia. A month later, he developed clinical and biochemical evidence of modest hepatocellular injury, and therapy was stopped. It was restarted 6 weeks later, and 10 weeks after that, the patient presented with fulminant hepatic failure, which resolved rapidly after cessation of nicotinic acid therapy. We suggest that nicotinic acid was the cause of his liver disease, that this case is of particular note because of the rather short period of therapy before the onset of liver injury and the severity of the hepatic failure, and that the probable increased use of nicotinic acid for serum cholesterol control makes it especially important for physicians and their patients to be alert to the signs of hepatotoxicity.

UI	MeSH Term	Description	Entries
D008111	Liver Function Tests	Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions.	Function Test, Liver,Function Tests, Liver,Liver Function Test,Test, Liver Function,Tests, Liver Function
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009525	Niacin	A water-soluble vitamin of the B complex occurring in various animal and plant tissues. It is required by the body for the formation of coenzymes NAD and NADP. It has PELLAGRA-curative, vasodilating, and antilipemic properties.	Nicotinic Acid,3-Pyridinecarboxylic Acid,Enduracin,Induracin,Lithium Nicotinate,Niacin Aluminum Salt,Niacin Ammonium Salt,Niacin Calcium Salt,Niacin Cobalt (2+) Salt,Niacin Copper (2+) Salt,Niacin Hydrochloride,Niacin Iron (2+) Salt,Niacin Lithium Salt,Niacin Lithium Salt, Hemihydrate,Niacin Magnesium Salt,Niacin Manganese (2+) Salt,Niacin Potassium Salt,Niacin Sodium Salt,Niacin Tartrate,Niacin Tosylate,Niacin Zinc Salt,Nicamin,Nico-400,Nicobid,Nicocap,Nicolar,Nicotinate,Wampocap,3 Pyridinecarboxylic Acid,Aluminum Salt, Niacin,Hydrochloride, Niacin,Nico 400,Nico400,Nicotinate, Lithium,Potassium Salt, Niacin,Sodium Salt, Niacin,Tartrate, Niacin,Tosylate, Niacin
D006501	Hepatic Encephalopathy	A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5)	Encephalopathy, Hepatic,Portosystemic Encephalopathy,Encephalopathy, Hepatocerebral,Encephalopathy, Portal-Systemic,Encephalopathy, Portosystemic,Fulminant Hepatic Failure with Cerebral Edema,Hepatic Coma,Hepatic Stupor,Hepatocerebral Encephalopathy,Portal-Systemic Encephalopathy,Coma, Hepatic,Comas, Hepatic,Encephalopathies, Hepatic,Encephalopathies, Hepatocerebral,Encephalopathies, Portal-Systemic,Encephalopathies, Portosystemic,Encephalopathy, Portal Systemic,Hepatic Comas,Hepatic Encephalopathies,Hepatic Stupors,Hepatocerebral Encephalopathies,Portal Systemic Encephalopathy,Portal-Systemic Encephalopathies,Portosystemic Encephalopathies,Stupor, Hepatic,Stupors, Hepatic
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006937	Hypercholesterolemia	A condition with abnormally high levels of CHOLESTEROL in the blood. It is defined as a cholesterol value exceeding the 95th percentile for the population.	Hypercholesteremia,Elevated Cholesterol,High Cholesterol Levels,Cholesterol Level, High,Cholesterol Levels, High,Cholesterol, Elevated,Cholesterols, Elevated,Elevated Cholesterols,High Cholesterol Level,Hypercholesteremias,Hypercholesterolemias,Level, High Cholesterol,Levels, High Cholesterol
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