Document Detail

A Rare Case of Propofol-Induced Acute Liver Failure and Literature Review.
MedLine Citation:
PMID:  21103229     Owner:  NLM     Status:  Publisher    
The incidence of drug-induced acute liver failure is increasing. A number of drugs can inhibit mitochondrial functions, alter β-oxidation and cause accumulation of free fatty acids within the hepatocytes. This may result in hepatic steatosis, cell death and liver injury. In our case, propofol, an anesthetic drug commonly used in adults and children, is suspected to have induced disturbance of the mitochondrial respiratory chain, which in consequence led to insufficient energy supply and finally liver failure. We report the case of a 35-year-old Caucasian woman with acute liver failure after anesthesia for stripping of varicose veins. Liver histology, imaging and laboratory data indicate drug-induced acute liver failure, presumably due to propofol. Hepatocyte death and microvesicular fatty degeneration of 90% of the liver parenchyma were observed before treatment with steroids. Six months later, a second biopsy was performed, which revealed only minimal steatosis and minimal periportal hepatitis. We suggest that propofol led to impaired fatty acid oxidation possibly due to a genetic susceptibility. This caused free fatty acid accumulation within hepatocytes, which presented as hepatocellular fatty degeneration and cell death. Large scale hepatocyte death was followed by impaired liver function and, consecutively, progressed to acute liver failure.
G Kneiseler; H S Bachmann; L P Bechmann; A Dechene; T Heyer; H Baba; F Saner; C Jochum; G Gerken; A Canbay
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-2-06
Journal Detail:
Title:  Case reports in gastroenterology     Volume:  4     ISSN:  1662-0631     ISO Abbreviation:  -     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474819     Medline TA:  Case Rep Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  57-65     Citation Subset:  -    
Division of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
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