The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index; none of the 20 sources its claims cite is checked for support yet.
Atorvastatin-Induced Liver Injury With Concurrent Rhabdomyolysis After a Positive Rechallenge
Open accessAbstract
Statin-induced liver injury has been widely described. However, cases of clinically significant liver injury are rare. We present a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury with concurrent rhabdomyolysis that worsened after rechallenging, which highlighted the need for pharmacovigilance with statins. The Roussel Uclaf Causality Assessment Method and Revised Electronic Causality Assessment Method both showed that atorvastatin was highly probable in causing hepatotoxicity. To our knowledge, this is the first reported case of concurrent drug-induced liver injury and rhabdomyolysis after a positive rechallenge with atorvastatin.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This case report describes a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury with concurrent rhabdomyolysis and acute renal failure requiring hemodialysis, worsening after atorvastatin rechallenge. The authors report this as the first case of concurrent drug-induced liver injury and rhabdomyolysis after a positive rechallenge with atorvastatin.
Key findings
- Initial presentation showed mixed liver injury with ALT 541, AST 1179, ALP 383, total bilirubin 15.8, INR 1.3, platelets 70, CK 1760, and R-factor 4.2; liver enzymes were normal 4 months earlier when atorvastatin 40 mg, clopidogrel 75 mg, and aspirin 81 mg were started.
- After atorvastatin rechallenge, liver enzymes rose within 5 days and peaked at ALT 1001, AST 4169, and ALP 623 with R-factor 4.8; she simultaneously developed severe rhabdomyolysis with peak CK 316,454 IU and acute renal failure requiring hemodialysis.
- Liver biopsy showed severe acute hepatitis with zone 3 necrosis and an eosinophil-predominant infiltrate with some plasma cells, suggestive of drug-induced liver injury.
- Causality assessment supported atorvastatin: RUCAM score 9 and RECAM score 14, both indicating atorvastatin as a highly probable cause; liver enzymes, renal function, and CK returned to normal over 3 months after permanent discontinuation.
Methods
- Design: single-patient case report from a liver transplant center.
- Data/sample: a 56-year-old woman with hypertension and ischemic cerebrovascular accident, no history of liver disease, presenting with confusion, jaundice, myalgias, and dark urine after atorvastatin exposure.
- Main analysis: descriptive clinical course, laboratory monitoring, liver biopsy, exclusion of other etiologies, and causality scoring using RUCAM and RECAM.
Limitations
- The paper states no limitations.
- Evident from the text: this is a single case report, so findings cannot establish incidence, causality in other patients, or generalizable risk.
- Evident from the text: the report does not describe genetic or pharmacogenetic testing, although it discusses SLCO1B1, CYP450, and HLA variants as risk factors for statin-associated DILI and rhabdomyolysis.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
0 of 20 cited sources checked · 0 supported · 0 flagged
- Findingown data
Liver biopsy demonstrated severe, acute neuroinflammatory hepatitis with zone 3 necrosis and an eosinophil predominant infiltrate with some plasma cells.
“To rule out other causes of ALI, liver biopsy was done and demonstrated severe, acute neuroinflammatory hepatitis with zone 3 necrosis and an eosinophil predominant infiltrate with some plasma cells (Figure 1).”
Quote in the paperSubstantial claim - Findingown data
On admission, labs were notable for ALT 541, AST 1179, ALP 383, total bilirubin 15.8, direct bilirubin 11.8, INR 1.3, platelets 70, and CK 1760.
“On admission, her laboratory results were notable for an alanine aminotransferase 541, aspartate aminotransferase (AST) 1179, alkaline phosphatase (ALP) 383, total bilirubin 15.8, direct bilirubin 11.8, international normalized ratio 1.3, platelets 70, and creatine kinase (CK) 1760.”
Quote in the paperSubstantial claim - Findingnone given
Initial workup was negative for viral, autoimmune, vascular, and other drug toxicity as potential etiologies of ALI.
“Initial workup was negative for viral, autoimmune, vascular, and other drug toxicity as potential etiologies of ALI.”
Quote in the paperSubstantial claim - Findingown data
The patient developed concurrent rhabdomyolysis.
“We report a case of a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury (ALI) complicated by rhabdomyolysis and acute renal failure requiring hemodialysis, with recurrence of liver injury on rechallenge.”
Quote in the paperSubstantial claim - Findingown data
Her liver enzymes peaked at ALT 1001, AST 4169, and ALP 623.
“Her liver enzymes peaked at an ALT 1001, AST 4169, and ALP 623.”
Quote in the paperNot a substantial claim
- Findingown data
A RECAM score of 14 provided evidence for atorvastatin as a highly probable cause of DILI.
“and a RECAM score of 14 (Table 2) also provided evidence for atorvastatin as a highly probable cause of DILI.”
Quote in the paperSubstantial claim - Findingown data
The patient was rechallenged with atorvastatin 40 mg.
“Given the new CVA, she was rechallenged with atorvastatin 40 mg.”
Quote in the paperSubstantial claim - Findingown data
R-factor was 4.8 indicating a similar mixed liver injury pattern.
“R-factor was 4.8 indicating a similar mixed liver injury pattern.”
Quote in the paperSubstantial claim - Findingown data
R-factor was 4.2 indicating mixed liver injury.
“R-factor was 4.2 indicating mixed liver injury.”
Quote in the paperNot a substantial claim - Findingown data
In this case, a RUCAM score of 9 suggested atorvastatin as a highly probable cause of ALI.
“In this case, a Roussel Uclaf Causality Assessment Method score of 9 (Table 1) suggested atorvastatin as a highly probable cause of ALI”
Quote in the paperSubstantial claim - Findingown data
The patient developed acute renal failure requiring hemodialysis.
“We report a case of a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury (ALI) complicated by rhabdomyolysis and acute renal failure requiring hemodialysis, with recurrence of liver injury on rechallenge.”
Quote in the paperSubstantial claim - Findingown data
The patient's liver injury recurred after rechallenge with atorvastatin.
“We report a case of a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury (ALI) complicated by rhabdomyolysis and acute renal failure requiring hemodialysis, with recurrence of liver injury on rechallenge.”
Quote in the paperSubstantial claim - Premisecitation
Coadministration of other drugs metabolized through CYP450 pathway such as certain antifungals, HIV protease inhibitors, fibrates, and macrolide antibiotics increases the risk of both DILI and rhabdomyolysis due to altered statin metabolism.
“Coadministration of other drugs that are metabolized through the CYP450 pathway such as certain antifungals, human immunodeficiency virus protease inhibitors, fibrates, and macrolide antibiotics increases the risk of both DILI and rhabdomyolysis due to altered statin metabolism.17,18”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [17] Hirota T Ieiri I. Drug-drug interactions that interfere with statin metabolism. Expert Opin Drug Metab Toxicol. 2015; 11(9): 1435– 47. 26058399
- cites [18] Gong Y Haque S Chowdhury P. Pharmacokinetics and pharmacodynamics of cytochrome P450 inhibitors for HIV treatment. Expert Opin Drug Metab Toxicol. 2019; 15(5): 417– 27. 30951643 PMC6497396
- Interpretationreasoning
In this patient, elevated INR, total bilirubin, ALT, and AST with only a mild elevation in CK on initial presentation provided evidence of true ALI.
“In our patient, an elevated international normalized ratio (INR), total bilirubin, ALT, and AST with only a mild elevation in CK on initial presentation provided evidence of true ALI.”
Quote in the paperSubstantial claim - Premisecitation
Atorvastatin was implicated in 8 of 22 (36.6%) patients with statin-related DILI in the US DILIN study.
“Atorvastatin was implicated in 8 of 22 (36.6%) patients with statin-related DILI in the US DILI Network study”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
- Interpretationown data
These biopsy findings were very suggestive of DILI as the cause of ALI.
“These findings were very suggestive of DILI as the cause of ALI.”
Quote in the paperSubstantial claim - Interpretationown data
The patient developed atorvastatin-induced grade III acute liver injury.
“We report a case of a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury (ALI) complicated by rhabdomyolysis and acute renal failure requiring hemodialysis, with recurrence of liver injury on rechallenge.”
Quote in the paperSubstantial claim
- It may state two separate claims as one. 10
- Probably not a substantial claim. 13
It may state two separate claims as one.
Findingown dataIV N-acetylcysteine was started, and liver enzymes and function improved over 3 days with labs improving to ALT 406, AST 792, INR 0.9, total bilirubin 3.1, and ALP 259.
“N-acetylcysteine was started, and her liver enzymes and function improved over the course of 3 days with laboratory values improving to ALT 406, AST 792, INR 0.9, total bilirubin 3.1, and ALP 259.”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
Findingown dataAtorvastatin was permanently discontinued, and her liver enzymes, renal function, and CK levels returned to normal with supportive management over 3 months.
“Atorvastatin was permanently discontinued, and her liver enzymes, renal function, and CK levels returned to normal with supportive management over the course of 3 months.”
Quote in the paperNot a substantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Findingown dataThe patient was a 56-year-old woman with hypertension and ischemic CVA and no history of liver disease.
“A 56-year-old woman with a history of hypertension and ischemic CVA and no history of liver disease presented as a transfer to our liver transplant center for the management of ALI.”
Quote in the paperNot a substantial claimIt may state two separate claims as one.
Findingown dataHer liver enzymes began to rise 5 days after statin reintroduction, and the patient redeveloped worsening hepatocellular injury.
“Her liver enzymes began to rise 5 days after statin reintroduction, and the patient redeveloped worsening hepatocellular injury.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataThe patient was initiated on atorvastatin 40 mg, clopidogrel 75 mg, and aspirin 81 mg for a CVA 4 months before presentation, and her liver enzymes were normal at that time.
“Of note, she was initiated on atorvastatin 40 mg, clopidogrel 75 mg, and aspirin 81 mg for a CVA that occurred 4 months before presentation, and her liver enzymes were normal at that time.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataThe patient was not on other new medications or herbal supplements in the year before and did not use alcohol or illicit substances.
“She was not on other new medications or herbal supplements in the year before and did not use alcohol or illicit substances.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Findingown dataShe developed severe rhabdomyolysis with a peak CK level of 316,454 IU complicated by acute renal failure requiring hemodialysis following the rechallenge.
“Simultaneously, she developed severe rhabdomyolysis with a peak CK level of 316,454 IU complicated by acute renal failure requiring hemodialysis following the rechallenge.”
Quote in the paperSubstantial claimIt may state two separate claims as one.
Interpretationown dataAlthough CK was markedly elevated with rechallenge, simultaneous liver biopsy demonstrated evidence of DILI.
“Although CK was markedly elevated with the rechallenge of atorvastatin, simultaneous liver biopsy demonstrated evidence of DILI.”
Quote in the paperSubstantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationThe incidence of statin-induced liver injury is estimated to be up to 3% in patients.
“The incidence of statin-induced liver injury is estimated to be up to 3% in patients with the majority of cases demonstrating only minor elevations in liver enzymes that often resolve spontaneously.4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationOf the statins currently available, the risk of DILI appears to be highest with atorvastatin based on data from the US DILIN prospective study and FDA FAERS database.
“Of the statins currently available, the risk of DILI appears to be highest with atorvastatin based on data collected from the US DILI Network prospective study and from the US Food and Drug Administration (FDA) Adverse Event Reporting System database.4,7”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
- cites [7] Kamimura H Setsu T Kimura N. Analysis of drug-induced liver-related adverse event trend reporting between 1997 and 2019. Hepatol Res. 2023; 53(6): 556– 68. 36680351
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationThe majority of statin-induced liver injury cases demonstrate only minor elevations in liver enzymes that often resolve spontaneously.
“The incidence of statin-induced liver injury is estimated to be up to 3% in patients with the majority of cases demonstrating only minor elevations in liver enzymes that often resolve spontaneously.4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
It may state two separate claims as one.
InterpretationreasoningThese findings suggested the presence of concurrent statin-induced DILI and severe rhabdomyolysis due to a clinically positive rechallenge of atorvastatin.
“These findings suggested the presence of concurrent statin-induced DILI and severe rhabdomyolysis due to a clinically positive rechallenge of atorvastatin.”
Quote in the paperSubstantial claimProbably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationVariants in SLCO1B1 gene have been linked to elevated statin levels, raising the risk of both DILI and rhabdomyolysis.
“Variants in the SLCO1B1 gene, which encodes a transporter protein involved in statin metabolism, have been linked to elevated statin levels in the blood, raising the risk of both DILI and rhabdomyolysis.14”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [14] Cooper-DeHoff RM Niemi M Ramsey LB. The clinical pharmacogenetics implementation consortium guideline for SLCO1B1, ABCG2, and CYP2C9 genotypes and statin-associated musculoskeletal symptoms. Clin Pharmacol Ther. 2022; 111(5): 1007– 21. 35152405 PMC9035072
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationPolymorphisms in various CYP450 enzymes and specific HLA alleles involved in statin metabolism may contribute to increased risk of liver injury and rhabdomyolysis.
“In addition, polymorphisms in various cytochrome P450 (CYP450) enzymes and specific human leukocyte antigen alleles involved in statin metabolism may contribute to an increased risk of liver injury and rhabdomyolysis.14–16”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [14] Cooper-DeHoff RM Niemi M Ramsey LB. The clinical pharmacogenetics implementation consortium guideline for SLCO1B1, ABCG2, and CYP2C9 genotypes and statin-associated musculoskeletal symptoms. Clin Pharmacol Ther. 2022; 111(5): 1007– 21. 35152405 PMC9035072
- cites [15] Fukunaga K Nakagawa H Ishikawa T Kubo M Mushiroda T. ABCB1 polymorphism is associated with atorvastatin-induced liver injury in Japanese population. BMC Genet. 2016; 17(1): 79. 27296832 PMC4906899
- cites [16] Nicoletti P Aithal GP Bjornsson ES. Association of liver injury from specific drugs, or groups of drugs, with polymorphisms in HLA and other genes in a genome-wide association study. Gastroenterology. 2017; 152(5): 1078– 89. 28043905 PMC5367948
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationThe overall incidence rate for statin-induced acute liver failure has been reported to be between 1 and 2 per 100,000 person-years.
“The overall incidence rate for statin-induced acute liver failure (ALF) has been reported to be between 1 and 2 per 100,000 person-years.2,5”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [2] Bays H Cohen DE Chalasani N Harrison SA; The National Lipid Association's Statin Safety Task Force. An assessment by the statin liver safety task force: 2014 update. J Clin Lipidol. 2014; 8(3 Suppl): S47– S57. 24793441
- cites [5] Karahalil B Hare E Koç G Uslu İ Şentürk K Özkan Y. Hepatotoxicity associated with statins. Arh Hig Rada Toksikol. 2017; 68(4): 254– 60. 29337684
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
PremisecitationOf the 22 statin-attributed DILI patients in the US DILIN study, 9 were hospitalized, 4 developed ALF, and 1 died.
“Of these 22 patients, 9 were hospitalized, and 4 developed ALF with 1 subsequent death.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationIn the US DILIN study of 1,188 clinically significant DILI cases (2004-2012), 22 were attributed to statins.
“Russo et al analyzed 1,188 cases of clinically significant DILI enrolled in the US Drug-Induced Liver Injury Network between 2004 and 2012, and 22 were attributed to statins.4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationAtorvastatin was found to be the fifth highest drug associated with DILI among all drug categories in the US FDA FAERS database from 1997 to 2019.
“and was found to the be the fifth highest drug associated with DILI among all drug categories in the US FDA Adverse Event Reporting System database from 1997 to 2019.4,7”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
- cites [7] Kamimura H Setsu T Kimura N. Analysis of drug-induced liver-related adverse event trend reporting between 1997 and 2019. Hepatol Res. 2023; 53(6): 556– 68. 36680351
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationClinically significant liver injury from statins is rare.
“However, cases of clinically significant liver injury are rare.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationIdiosyncratic drug-induced liver injury from statins has been well described.
“Although statins are generally well tolerated, adverse events, such as rhabdomyolysis, and idiosyncratic drug-induced liver injury (DILI) have been well described.2”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2] Bays H Cohen DE Chalasani N Harrison SA; The National Lipid Association's Statin Safety Task Force. An assessment by the statin liver safety task force: 2014 update. J Clin Lipidol. 2014; 8(3 Suppl): S47– S57. 24793441
Probably not a substantial claim. The paper’s conclusions may not depend on it.
PremisecitationThe incidence of statin-related DILI remains low at 1.9% based on the US DILIN study.
“However, the incidence of statin-related DILI remains low at 1.9% based on the US DILI Network study.4”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [4] Russo MW Hoofnagle JH Gu J. Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network. Hepatology. 2014; 60(2): 679– 86. 24700436 PMC4110177
The paper relies on this without support.
No prior case of concurrent DILI and rhabdomyolysis after a positive rechallenge with atorvastatin has been reported.
“To our knowledge, this is the first reported case of concurrent drug-induced liver injury and rhabdomyolysis after a positive rechallenge with atorvastatin.”
“To our knowledge, this is the first reported case of concurrent DILI and rhabdomyolysis after a positive rechallenge with atorvastatin and demonstrated the continued need for pharmacovigilance in statin-related adverse effects.”
Citations
Cites
Cooper‐DeHoff, R. M., Niemi, M., Ramsey, L. B., Luzum, J. A., Tarkiainen, E. K., Straka, R. J., Gong, L., Tuteja, S., Wilke, R. A., Wadelius, M., et al. (2022) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.2557 · Cited by 366
Spectrum of statin hepatotoxicity: Experience of the drug-induced liver injury network
Russo, M. W., Hoofnagle, J. H., Gu, J., Fontana, R. J., Barnhart, H. X., Kleiner, D. E., Chalasani, N., & Bonkovsky, H. L. (2014) · Hepatology · doi:10.1002/hep.27157 · Cited by 245
An assessment by the Statin Liver Safety Task Force: 2014 update
Bays, H. E., Cohen, D. E., Chalasani, N., & Harrison, S. A. (2014) · Journal of clinical lipidology · doi:10.1016/j.jacl.2014.02.011 · Cited by 232
Nicoletti, P., Aithal, G. P., Bjornsson, E. S., Andrade, R. J., Sawle, A., Arrese, M., Barnhart, H. X., Bondon-Guitton, E., Hayashi, P. H., Bessone, F., et al. (2017) · Gastroenterology · doi:10.1053/j.gastro.2016.12.016 · Cited by 221
Abnormal liver function tests associated with severe rhabdomyolysis
Lim, A. K. H. (2020) · World Journal of Gastroenterology · doi:10.3748/wjg.v26.i10.1020 · Cited by 126
Statin-induced Liver Injury Patterns: A Clinical Review
Averbukh, L. D., Turshudzhyan, A., Wu, D. C., & Wu, G. Y. (2022) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2021.00271 · Cited by 96
Drug–drug interactions that interfere with statin metabolism
Hirota, T., & Ieiri, I. (2015) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1517/17425255.2015.1056149 · Cited by 84
Pharmacokinetics and pharmacodynamics of cytochrome P450 inhibitors for HIV treatment
Gong, Y., Haque, S., Chowdhury, P., Cory, T. J., Kodidela, S., Yallapu, M. M., Norwood, J. M., & Kumar, S. (2019) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2019.1604685 · Cited by 82
Sharpton, S. R., & Loomba, R. S. (2023) · Hepatology · doi:10.1097/hep.0000000000000278 · Cited by 60
Considerations for safe use of statins: liver enzyme abnormalities and muscle toxicity.
Gillett, R. C., & Norrell, A. (2011) · PubMed · Cited by 59
Hepatotoxicity associated with statins
Karahalıl, B., Hare, E., Koç, G., Uslu, İ., Şentürk, K., & Özkan, Y. (2017) · Archives of Industrial Hygiene and Toxicology · doi:10.1515/aiht-2017-68-2994 · Cited by 58
ABCB1 polymorphism is associated with atorvastatin-induced liver injury in Japanese population
Fukunaga, K., Nakagawa, H., Ishikawa, T., Kubo, M., & Mushiroda, T. (2016) · BMC Genetics · doi:10.1186/s12863-016-0390-5 · Cited by 37
Epidemiology and Management of Drug-induced Liver Injury: Importance of the Updated RUCAM
Kobayashi, T., Iwaki, M., Nogami, A., & Yoneda, M. (2023) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2022.00067s · Cited by 32
RECAM: A New and Improved, Computerized Causality Assessment Tool for DILI Diagnosis
Hayashi, P. H., Lucena, M. I., & Fontana, R. J. (2022) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001836 · Cited by 28
Teschke, R., & Danan, G. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241310855 · Cited by 25
Analysis of drug‐induced liver‐related adverse event trend reporting between 1997 and 2019
Kamimura, H., Setsu, T., Kimura, N., Miyazawa, M., Kaneko, S., Kamimura, K., Tsuchiya, A., Uesawa, Y., & Terai, S. (2023) · Hepatology Research · doi:10.1111/hepr.13883 · Cited by 17
Idiosyncratic Drug-Induced Acute Liver Failure: A Challenging and Distressing Scenario
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Digitizing DILI: Who can? RUCAM? RECAM?
Lewis, J. H. (2022) · Hepatology · doi:10.1002/hep.32312 · Cited by 4
Self-citation
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Cited by
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(2025) · Reactions Weekly · doi:10.1007/s40278-025-75340-1
Toxicities and adverse reactions associated with lipid-lowering medications
Moradi, L. (., & Malik, N. N. (2025) · Side effects of drugs annual · doi:10.1016/bs.seda.2025.10.005
Zhang, H., Zhao, P., Huang, H., & Zeng, Y. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.2003438
Metadata
- Authors
- Singh, H., Khalaf, A., Kunkle, B. F., Gholami, S., Lewis, J. H., & Rangnekar, A. S.
- Affiliations
- MedStar Georgetown University Hospital (US)
- Corresponding author
- Singh, Harjit
- Venue
- ACG Case Reports Journal
- Published
- 2024-12-30
- Volume
- 12
- Issue
- 1
- Pages
- e01570
- ISSN
- 2326-3253 (ISSN-L)
- PMC
- PMC11688008
- OpenAlex
- W4405893124
- Semantic Scholar
- 77ba86873e95dbd74f689a98c608cdf25dffc99f
- Cited by
- 3
- References
- 18
- Citations by year
- 2026: 1 · 2025: 2
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- ACG Case Reports Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
- Keywords
- atorvastatin, drug-induced liver injury, rhabdomyolysis, drug rechallenge, pharmacovigilance, RUCAM, adverse drug reactions
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