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According to one article, hepatic reactions have accounted for 4.2% of all adverse drug reactions and 7.4% of all fatal occurrences in New Zealand, erythromycin, diclofenac, clavulanic acid plus amoxicillin, floxacillin, halothane, and perhexiline maleate being among the drugs most commonly involved.¹ The cholesterol-lowering -hydroxy--methylglutaryl-coenzyme A reductase inhibitors (statins) can induce liver dysfunction in a few patients,² resulting in mild and asymptomatic increases in liver enzyme levels and, rarely, acute cholestatic hepatitis.^3-4 Atorvastatin calcium is a new statin whose safety profile appears to be similar to that seen in all drugs of this group.⁵ Fifty-six of our patients with hypercholesterolemia were treated with atorvastatin in 1998. Eight of the 56 patients were women with systemic lupus erythematosus, one of whom developed acute cholestatic hepatitis after the initiation of the atorvastatin therapy. The latter patient, a 20-year-old white woman with musculoskeletal symptoms, malar rash, fever, leukopenia, and elevated levels of . . . [Full Text of this Article]

Juan Jiménez-Alonso, MD; José Manuel Osorio, MD; Francisco Gutiérrez-Cabello, MD; Aquilino López de la Osa, MD; Laura León, MD; Juan Diego Mediavilla García, MD
Granada, Spain

for the Grupo Lupus Virgen de las Nieves

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