Naproxen as a cause of acute cholestatic hepatitis: a case report

BACKGROUND: Drug-induced liver injury is a common cause of acute liver injury and acute liver failure worldwide, and nonsteroidal antiinflammatory drugs are the third most common pharmaceutical group related with its development. Between nonsteroidal antiinflammatory drugs, naproxen is a propionic derivate widely used and generally safe drug. CASE PRESENTATION: We present an 83 year-old Caucasian male patient with cholestatic acute liver injury secondary to naproxen with associated cholemic nephropathy and atrioventricular block during admission. The patient was managed with one session of plasma exchange, forced diuresis, ursodeoxycholic acid, and a short course of corticosteroids. CONCLUSION: Given the rarity of this phenomenon, we report this case to support the limited evidence available, particularly in the light of the widespread and routine utilization of nonsteroidal antiinflammatory drugs by a significant proportion of the population.