Nimesulide-induced acute hepatitis

OBJECTIVE: To report the occurrence of nimesulide-induced acute hepatitis c onfirmed by biopsy and an in vitro lymphocyte toxicity assay. CASE SUMMARY: A 54-year-old Arabic woman treated with nimesulide for chroni c low back pain was admitted to the hospital with acute hepatitis confirmed by biopsy. Her liver function test results returned to normal within one m onth after nimesulide discontinuation. An in vitro lymphocyte toxicity assa y confirmed that the liver injury was due to nimesulide exposure. DISCUSSION: A case of acute hepatitis secondary to nimesulide, confirmed by biopsy and a laboratory in vitro assay, is described, Although the occurre nce of clinically significant liver damage due to nonsteroidal antiinflamma tory drugs (NSAIDs) is low, the enormous consumption of these drugs has mad e them an important cause of liver damage. Nimesulide, a relatively new NSA ID commonly used in Europe, with a relative selectivity to cyclooxygenase t ype 2, can cause a wide range of liver injuries, from mild abnormal liver f unction to severe liver injuries. These effects are usually reversible on d iscontinuation of the drug, but occasionally can progress to fatal hepatic failure. CONCLUSIONS: Drug-induced acute hepatitis is a well-recognized adverse effe ct of many drugs, including nimesulide. Identification of a drug as a cause for this life-threatening disease is important because the discontinuation of it may be life saving. This article confirms the occurrence of nimesuli de-induced hepatitis. It also highlights the importance of monitoring liver function test results after initiating therapy with such a drug.