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Case report
Anastrozole-induced liver injury after a prolonged latency: a very rare complication of a commonly prescribed medication
  1. Chencheng Xie1,
  2. Hafez Mohammad Ammar Abdullah1,
  3. Mohamed Abdallah1,
  4. Erin Quist2 and
  5. Mumtaz Niazi3
  1. 1 Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA
  2. 2 Depratment of Pathology, Avera Mckennan University Health Center, Sioux Falls, South Dakota, USA
  3. 3 Division of Gastroenterology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
  1. Correspondence to Dr Hafez Mohammad Ammar Abdullah; ammar.abdullah{at}


Anastrozole is an aromatase inhibitor that has been used more frequently over the last decade especially for oestrogen receptor-positive breast cancer. It has a relatively safe side effect profile. However, occasionally it has been associated with serious adverse events. Here, we present the case of a 58-year-old woman who presented with significantly elevated liver enzymes 4 years after starting anastrozole. She was not taking any other medications and an extensive workup did not reveal any other cause for her liver injury. The patient’s liver enzymes normalised after discounting the anastrozole. She scored 4 on the updated Roussel Uclaf Causality Assessment Method grading system which was possible for drug-induced liver injury. A review of the literature revealed six prior cases of anastrozole-related liver injury. Anastrozole should be considered as a possible culprit in patients who develop an unexplained acute liver injury.

  • drug interactions
  • gastrointestinal system
  • liver disease
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  • Contributors CX and HMAA were responsible for writing the discussion and background parts. MA, EQ and MN were responsible for the summary and case presentation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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