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Case Reports
. 2016 Dec;22(4):495-498.
doi: 10.3350/cmh.2016.0023. Epub 2016 Dec 25.

A case of levocetirizine-induced liver injury

Moon Chan Jung  1 , Ja Kyung Kim  1   2 , Jae Yeon Cho  1 , Jae Won Song  1 , Bohyun Lee  1 , Ji Won Park  1   2 , Jinwon Seo  3 , Sung Eun Kim  1   2
Affiliations
Case Reports

A case of levocetirizine-induced liver injury

Moon Chan Jung et al. Clin Mol Hepatol. 2016 Dec.

Abstract

Levocetirizine is a second-generation nonsedative antihistaminic agent that has been demonstrated to be safe and effective for treating allergic disease. There was only one case report of levocetirizine-induced liver toxicity, but a liver biopsy was not performed. In this article, we present the first case of levocetirizine-induced liver injury with histologic findings. A 48-year-old man was hospitalized with jaundice and generalized pruritus that had developed after 2 months of therapy with levocetirizine for prurigo nodularis. Laboratory findings revealed acute hepatitis with cholestasis. A liver biopsy demonstrated portal inflammation and hepatitis with apoptotic hepatocytes. The patient fully recovered 3 weeks after withdrawing levocetirizine. Although levocetirizine is safe and effective, physicians should be aware of its potential hepatotoxicity.

Keywords: Cholestasis; Hepatotoxicity; Levocetirizine.

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Conflict of interest statement

The authors have no conflicts to disclose.

Figures

Figure 1.
Figure 1.
(A) Liver biopsy tissue (H&E, ×200) showing patchy portal inflammation and hepatocyte dropout. Portal and periportal inflammation is evident. (B) The hepatic parenchyme also shows multifocal hepatocellular dropouts with apoptotic hepatocytes.
Figure 2.
Figure 2.
Changes in laboratory parameters over time: (A) total bilirubin (TB) and direct bilirubin (DB), (B) aspartate aminotransferase (AST) and alanine aminotransferase (ALT), (C) alkaline phosphatase (ALP), and (D) prothrombin time (PT).
See this image and copyright information in PMC

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