CC BY-NC-ND 4.0 · AJP Rep 2020; 10(03): e210-e212
DOI: 10.1055/s-0040-1713789
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Labetalol-Induced Hepatotoxicity during Pregnancy: A Case Report

Anna Whelan
1   Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Chicago, Chicago, Illinois
,
Joanna Izewski
1   Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Chicago, Chicago, Illinois
,
Charles Berkelhammer
2   Department of Gastroenterology, Advocate Christ Medicine Center, Oak Lawn, Illinois
,
Jami Walloch
3   Department of Pathology, Advocate Christ Medical Center, Oak Lawn, Illinois
,
Helen H. Kay
4   Department of Maternal-Fetal Medicine, Advocate Christ Medical Center, Oak Lawn, Illinois
› Author Affiliations
Further Information

Publication History

15 February 2020

07 March 2020

Publication Date:
04 August 2020 (online)

Abstract

Background Drug-induced liver injury is a common cause of transaminitis, occurring in up to 5% of patients who are hospitalized for liver failure. In pregnancy, transaminitis is seen in conditions which may require expedited delivery.

Case A 39-year-old G2P0010 at 272/7 weeks' gestation with chronic hypertension on labetalol was found to have elevated transaminases. Evaluation for preeclampsia, acute fatty liver, nonalcoholic steatohepatitis, cholelithiasis, infections, and autoimmune conditions were all negative. Labetalol was then discontinued, and liver biopsy was performed. After discontinuation of labetalol, her hepatitis improved, and she was discharged on hospital day 12 and went on to deliver at term.

Conclusion Labetalol-induced hepatitis should be considered in the differential for transaminitis during pregnancy to prevent iatrogenic preterm delivery.

Disclosure

The authors have nothing to disclose.


Note

This case report was presented as a poster at the ACOG 2019 Annual Meeting on May 3–6, 2019, in Nashville, TN.


 
  • References

  • 1 Stronkhorst A, Bosma A, van Leeuwen DJ. A case of labetalol-induced hepatitis. Neth J Med 1992; 40 (3-4): 200-202
  • 2 Lee WM. Drug-induced hepatotoxicity. N Engl J Med 2003; 349 (05) 474-485
  • 3 Douglas DD, Yang RD, Jensen P, Thiele DL. Fatal labetalol-induced hepatic injury. Am J Med 1989; 87 (02) 235-236
  • 4 ACOG Practice Bulletin No. 203: chronic hypertension in pregnancy. Obstet Gynecol 2019; 133 (01) e26-e50
  • 5 Grassin Delyle S, Duverneuil-Mayer C, Abe E. , et al. Fatal intoxication with labetalol (Trandate). Forensic Sci Int 2008; 178 (2-3): e19-e21
  • 6 McNeil JJ, Louis WJ. Clinical pharmacokinetics of labetalol. Clin Pharmacokinet 1984; 9 (02) 157-167
  • 7 Clark JA, Zimmerman HJ, Tanner LA. Labetalol hepatotoxicity. Ann Intern Med 1990; 113 (03) 210-213
  • 8 Long RC, Wofford MR, Harkins KG, Minor DS. Hepatocellular necrosis associated with labetalol. J Clin Hypertens (Greenwich) 2007; 9 (04) 287-290