Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2021; 9(30): 9295-9301
Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9295
Biopsy-confirmed fenofibrate-induced severe jaundice: A case report
Hye Young Lee, Ae-Ra Lee, Jeong-Ju Yoo, Susie Chin, Sang Gyune Kim, Young Seok Kim
Hye Young Lee, Ae-Ra Lee, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea
Susie Chin, Department of Pathology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, South Korea
Author contributions: Lee HY and Lee AR contributed equally to this manuscript; Lee HY and Lee AR draft the original manuscript and managed the data; Yoo JJ contributed to the conceptualization, investigation, project administration and reviewed and edited the manuscript; Lee HY contributed to the formal analysis, visualization and provided the resources; Kim SG contributed to the methodology and supervision; all authors approval of final manuscript.
Supported by Soonchunhyang University Research Fund, No. 20200037.
Informed consent statement: Informed consent statement was waived due to the retrospective nature of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016). The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeong-Ju Yoo, MD, Professor, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jomaruro, Bucheon 14584, South Korea. puby17@naver.com
Received: June 6, 2021
Peer-review started: June 6, 2021
First decision: June 25, 2021
Revised: July 5, 2021
Accepted: August 27, 2021
Article in press: August 27, 2021
Published online: October 26, 2021
Abstract
BACKGROUND

Drug-induced liver injury (DILI) is the leading cause of acute liver failure in the United States. DILI is mainly caused by painkillers and fever reducers, and it is often characterized by the type of hepatic injury (hepatocellular or cholestatic). This report presents a case of fenofibrate-induced severe jaundice in a 65-year-old Korean male with no prior history of liver disease. We offer a strategy for patients who present signs of severe liver injury with jaundice and high elevations in serum transaminases.

CASE SUMMARY

A 65-year-old male visited the gastroenterology outpatient clinic of a tertiary hospital due to increased levels of liver enzyme and total bilirubin which were incidentally detected through a preoperative screening test. Abdominal ultrasound and computed tomography showed no biliary obstruction or non-specific findings in the liver. Liver biopsy was performed and the patient was finally diagnosed with acute cholestatic hepatitis. Following the biopsy, steroid therapy was initiated and after 3 wk of treatment, the total bilirubin level was reduced to 7.22 mg/dL.

CONCLUSION

In patients with hyperlipidemia, treatment including fenofibric acid induces rare complications such as severe jaundice and acute cholestatic hepatitis, warranting clinical attention.

Keywords: Drug-induced liver injury, Toxic hepatitis, Fenofibrate, Fenofibric acid, Jaundice, Hepatotoxicity, Hyperlipidemia, Case report

Core Tip: In patients with hyperlipidemia, treatment including fenofibric acid causes rare complications such as severe jaundice and acute cholestatic hepatitis, which requires clinical attention.