Clinical case: drug-induced liver injury in a patient 84 years old


DOI: https://dx.doi.org/10.18565/therapy.2021.1.131-139

Alieva A.M., Almazova I.I., Baykova I.E., Tsar A.A., Salasar Abrigo G.F., Kislyakov V.A., Pinchuk T.V., Elmurzayeva D.A., Modestova A.V., Ettinger O.A., Totolyan G.G., Kadyrova R.K., Tikhomirova A.S., Reznik E.V., Nikitin I.G.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, Moscow; 3) Kh.M. Berbekov Kabardino-Balkarian State University of the Ministry of Science and Higher Education of Russia, Nalchik
Abstract. According to the statistics, 1 case of drug-induced liver injury is registered per 10,000 populations. Almost any drug is able to result in drug-induced liver injury. However, the main groups of drugs that most often lead to this pathology have been identified. In this article we will talk about a patient with drug-induced liver injury that has developed after taking a group of statins (simvastatin) and paracetamol. With age, especially in patients over 65, as in this clinical case, the frequency of side effects of drugs increases. This is due to a decrease in the metabolic activity of liver enzymes, reducing the mass of the liver, a decrease in blood flow rate. DILI is actually an exception diagnosis that requires careful differential diagnosis.
Keywords: drug-induced liver injury, statins, paracetamol, side effects, hepatotoxicity, coronary heart disease, arterial hypertension, fermentemia
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About the Autors

Amina M. Alieva, PhD, associate professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (906) 733-08-31. E-mail: amisha_alieva@mail.ru
Ilda I. Almazova, physician-teacher of National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101990, Moscow, 10 Petroverigsky Lane. Tel.: +7 (916) 903-94-83. E-mail: almazovai@rambler.ru
Irina E. Baykova, PhD, associate professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (903) 149-85-53. E-mail: 1498553@mail.ru
Alina A. Tsar, student of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 705-30-33. E-mail: alin.zara@yandex.ru
Gabriella F. Salasar Abrigo, student of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (968) 811-01-96. E-mail: salasarabrigo-gf@yandex.ru
Vladimir A. Kislyakov, PhD, associate professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 628-21-64. E–mail: kvadoctor@mail.ru
Tatyana V. Pinchuk, PhD, associate professor of the Department of internal therapy of the pediatrics faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 174-78-74. E-mail: doktor2000@inbox.ru
Jannet A. Elmurzayeva, PhD, associate professor of Department of microbiology, virusology and immunology of Kh.M. Berbekov Kabardino-Balkarian State University of the Ministry of Science and Higher Education of Russia. Address: 360004, Nalchik, 173 Chernyshevskogo Str. Tel.: +7 (928) 712-83-19. E-mail: jannet.elmurzaeva@yandex.ru
Anna V. Modestova, PhD, associate professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 175-33-45. E-mail: a.modestowa@yandex.ru
Olga A. Ettinger, PhD, associate professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 136-54-26. E-mail: olga-oett@mail.ru
Gayane G. Totolyan, PhD, associate professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 248-90-11. E-mail: tgg03@mail.ru
Raziyat K. Kadyrova, teacher of the highest category of the Medical College of Kh.M. Berbekov Kabardino-Balkarian State University of the Ministry of Science and Higher Education of Russia. Address: 360000, Nalchik, 17 Gorky Str. Tel.: +7 (928) 083-48-66. E-mail: Kadirova47@yandex.ru
Anna S. Tikhomirova, assistant of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Director of the Medical Rehabilitation Center of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (926) 221-61-15. E-mail: strelka_90@inbox.ru
Elena V.Reznik, MD, professor of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 380-39-23. E-mail: elenaresnik@gmail.com
Igor G. Nikitin, MD, professor, head of the Department of hospital therapy No. 2 of the faculty of general medicine of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 161-57-27. E-mail: igor.nikitin.64@mail.ru

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