HEPATOTOXICIDAD INDUCIDA POR MEDICAMENTO EN UN PACIENTE AMBULATORIAL: RELATO DE CASO
Nília Maria de Brito Lima Prado, Gladistone Correia Messias, Genario Oliveira Santos Junior, Raymundo Paraná

Drug-induced hepatitis, also called toxic hepatitis or Drug-Induced Liver Injury (DILI), accounts for approximately 2% of hospitalization for jaundice cases, and the liver is involved in 3-10% of all adverse drug reactions (ADRs). The cases of liver injury associated with the use of ibuprofen are rare and the frequency of idiosyncratic hepatotoxicity is small. Objective: To report a case of drug-induced liver injury identified in a medium complexity ambulatory. Case report: Female patient, 48 years old, admitted in a specialized Care Center in a city in the southwestern region of the State of Bahia, referred to the health service for an appointment with an orthopedist, complaining of severe pain in the column. She started drug treatment with ibuprofen and dipyrone sodium in case of pain. It was requested for the patient at the time of initial clinical evaluation, to perform liver function tests, aiming to rule out previous liver injury. After 15 days of treatment, the patient returned to the service, complaining of joint pain in upper limbs and edemas on every finger of the right hand, dark urine, light stools, body aches, insomnia, asthenia, and intense itching especially at night, negative viral and autoimmune markers. A total abdomen ultrasound showed slight abnormal liver texture, a moving gallstone, thus suggesting choledocolithiasis. Applying RUCAM, the reaction highly probable. Conclusion: The liver injury shown by the patient has a strong causal relationship to the use of ibuprofen.

Descriptores: Hepatotoxicidad, ibuprofeno, hepatitis toxica