LOVASTATIN-INDUCED ACUTE CHOLESTATIC HEPA TITIS

Acute cholestatic hepatitis developed in two patients, a 58-year-old m an and a 54-year-old woman, who had been treated for hypercholesterola emia with the cholesterol-synthesis inhibitor lovastatin for 3 years a nd 2 months, respectively. Both of them at first complained only of ti redness and loss of appetite, but then developed jaundice with colourl ess stool and dark urine. Alkaline phosphatase concentration rose up t o maximally 1227 and 569 U/l, gamma-GT to 403 and 410 U/l, respectivel y. The transaminases and glutamate dehydrogenase were also elevated, w hile serum cholesterinase had fallen to 2346 and 2418 U/l, respectivel y. Histological examination of liver biopsies 6 months and 4 weeks, re spectively, after onset of jaundice also suggested drug-toxic liver da mage. There was no evidence for other causes. After lovastatin had bee n discontinued the various cholestasis parameters regressed only slowl y.