Acute liver injury secondary to sertraline

BMJ Case Rep. 2013 Sep 26:2013:bcr2013201022. doi: 10.1136/bcr-2013-201022.

Abstract

Sertraline is widely prescribed to treat depression and anxiety disorders. However, hepatitis secondary to its use is a rare entity. We report the case of a 26-year-old woman in her 20th week of pregnancy presented with nausea, vomiting, malaise and dark urine. This occurred 6 months after sertraline 50 mg daily was started for the treatment of depression. Three weeks prior to her presentation, the dose of sertraline was increased to 100 mg daily. The patient's liver biochemical profile demonstrated increased transaminases. The biopsy of the liver showed lobular hepatitis, with a mild prominence of eosinophils, suggestive of a drug-induced or toxin-induced aetiology. Extensive biochemical work-up failed to show any other pathology to account for her hepatitis. Liver function tests normalised after cessation of sertraline, indicating a probable association between sertraline use and acute hepatocellular injury in our patient.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Biopsy
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / etiology*
  • Depression / drug therapy
  • Diagnosis, Differential
  • Female
  • Humans
  • Liver / drug effects
  • Liver / pathology*
  • Pregnancy
  • Pregnancy Complications*
  • Sertraline / adverse effects*
  • Sertraline / therapeutic use

Substances

  • Antidepressive Agents
  • Sertraline