J Pediatr Intensive Care 2021; 10(02): 152-154
DOI: 10.1055/s-0040-1710496
Case Report

Dantrolene-Induced Hepatitis: A Rare Culprit in the PICU

1   Department of Pediatric Critical Care, Oishei Children's Hospital, University of Buffalo, Buffalo, New York, United States
Shilpi Gupta
2   Department of Internal Medicine, Mercy Hospital of Buffalo, Buffalo, New York, United States
Amanda Hassinger
1   Department of Pediatric Critical Care, Oishei Children's Hospital, University of Buffalo, Buffalo, New York, United States
› Author Affiliations
Funding None.


Dantrolene is used for reversal of malignant hyperthermia and for improvement in spasticity following stroke which are Food and Drug Administration-approved indications. It is an infrequently used medication in the pediatric intensive care unit and is usually continued from the operating room or sedation suite after suspicion for malignant hyperthermia, secondary to other medications and anesthetic agents. Hepatitis has been described as a side effect of the medication after prolonged use and at doses of more than 100 mg/d mainly in adults. We described in this case report a patient in which the drug was used for sympathetic overactivity in the PICU and development of asymptomatic hepatitis on day 3 after starting the medication at a dose much lower than previously described.

Authors' Contributions

D. P. was primarily involved in preparation of manuscript. S. G. and A. H. provided assistance with literature review and manuscript submission.

Publication History

Received: 30 September 2019

Accepted: 06 April 2020

Article published online:
05 June 2020

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  • References

  • 1 USFDA- Drug database; DANTROLENE SODIUM; Label - supplement 49. Accessed November, 2019 at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/205579s000lbl.pdf
  • 2 Ward A, Chaffman MO, Sorkin EM. Dantrolene. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in malignant hyperthermia, the neuroleptic malignant syndrome and an update of its use in muscle spasticity. Drugs 1986; 32 (02) 130-168
  • 3 Denhoff E, Feldman S, Smith MG, Litchman H, Holden W. Treatment of spastic cerebral-palsied children with sodium dantrolene. Dev Med Child Neurol 1975; 17 (06) 736-742
  • 4 Utili R, Boitnott JK, Zimmerman HJ. Dantrolene-associated hepatic injury. Incidence and character. Gastroenterology 1977; 72 (4 Pt 1): 610-616
  • 5 Chan CH. Dantrolene sodium and hepatic injury. Neurology 1990; 40 (09) 1427-1432
  • 6 Kim JY, Chun S, Bang MS, Shin HI, Lee SU. Safety of low-dose oral dantrolene sodium on hepatic function. Arch Phys Med Rehabil 2011; 92 (09) 1359-1363
  • 7 Wilkinson SP, Portmann B, Williams R. Hepatitis from dantrolene sodium. Gut 1979; 20 (01) 33-36
  • 8 Guengerich FP, MacDonald JS. Applying mechanisms of chemical toxicity to predict drug safety. Chem Res Toxicol 2007; 20 (03) 344-369