NIACIN-INDUCED HEPATOTOXICITY - UNUSUAL PRESENTATIONS

We report four cases of niacin-induced hepatotoxicity. All four patien ts were using sustained-release niacin preparations. When they stopped taking niacin, symptoms and laboratory abnormalities resolved. Two of the patients had focal fatty infiltration of the liver on imaging stu dies, a presentation of niacin hepatotoxicity not previously described . One patient had a coagulopathy even though aminotransferase levels w ere only mildly elevated. We recommend that patients using sustained-r elease preparations of niacin have periodic monitoring of liver enzyme s and that the preparation be discontinued if any abnormalities develo p.