TY - JOUR T1 - Hydralazine-induced liver injury: a review and discussion JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2021-243278 VL - 14 IS - 8 SP - e243278 AU - Meeta Bhardwaj AU - Nakul Jay Bhardwaj AU - Kendra Cueto AU - T Colin Killeen Y1 - 2021/08/01 UR - http://casereports.bmj.com/content/14/8/e243278.abstract N2 - Hydralazine is a commonly prescribed antihypertensive agent. Some of its labelled adverse reactions include lupus-like syndrome, tachycardia, headache and fever. Despite its well-known side effects, little is known about hydralazine’s hepatotoxic effects. We report the case of a 54-year-old female patient who was started on hydralazine for hypertension management but later presented with hydralazine-induced liver injury. Her initial presentation consisted of non-specific symptoms and a hepatocellular injury pattern. Liver biopsy revealed hepatic steatosis. Three weeks after discontinuation of hydralazine, the patient’s liver enzymes normalised, and her symptoms resolved. Few studies have examined the incidence and mechanism by which hydralazine induces a liver injury pattern. With this case, we review the literature, the pathogenesis involved and the eventual management of hydralazine-induced liver injury. We propose close monitoring of liver enzymes for patients on hydralazine throughout their treatment course. ER -