Skip to main content

CASE REPORT article

Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1492002
This article is part of the Research Topic Case Reports in Hepatobiliary Diseases View all 11 articles

Persistent hepatocyte secretory failure in lopinavir/ritonavir related to drug-induced liver injury: A case report

Provisionally accepted
Yue Sun Yue Sun 1Ran Wang Ran Wang 2Cai'e Wang Cai'e Wang 3Xiaodong Shao Xiaodong Shao 2Xiaojie Zheng Xiaojie Zheng 4Hui Li Hui Li 3Yingkai Chi Yingkai Chi 5Baocheng Deng Baocheng Deng 6Yiling Li Yiling Li 7Shenghao Jin Shenghao Jin 8Xingshun Qi Xingshun Qi 1*
  • 1 (Teaching Hospital of Dalian Medical University), Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China
  • 2 Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China
  • 3 (Teaching Hospital of Shenyang Pharmaceutical University), Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China
  • 4 (Teaching Hospital of China Medical University), Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China
  • 5 Department of pathology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China
  • 6 Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
  • 7 Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
  • 8 School of Clinical Medicine, China Medical University, Shenyang, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Lopinavir/ritonavir, an anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) drug, may be associated with the development of liver injury. In this paper, we reported an elderly female patient with drug-induced liver injury secondary to lopinavir/ritonavir, which was evaluated for their causality using the updated Roussel Uclaf Causality Assessment Method (RUCAM) of 2016. She had a RUCAM score of 8 which was equivalent to a probable causality grading. Her clinical course was complicated by persistent hepatocyte secretion failure (PHSF), followed by septic shock and SARS-CoV-2 re-infection during her hospitalization. Her response to any medical intervention, including ursodeoxycholic acid, glutathione, methylprednisolone sodium succinate, rifampicin, artificial liver support, and endoscopic nasobiliary drainage (ENBD) was very poor, and her family members refused liver transplantation. Finally, she died. In summary, this case suggests the possibility that lopinavir/ritonavir can cause DILI and even PHSF in our clinical practice.

    Keywords: case report, Drug-Induced Liver Injury, persistent hepatocyte secretion failure, Lopinavir/ritonavir, updated RUCAM

    Received: 06 Sep 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Sun, Wang, Wang, Shao, Zheng, Li, Chi, Deng, Li, Jin and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xingshun Qi, (Teaching Hospital of Dalian Medical University), Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.