[Pregabalin as a rare cause of liver disease].

UNLABELLED: In this report we describe a patient who developed liver failure due to new administration of pregabaline.

HISTORY AND ADMISSION FINDINGS: A 76-year old woman was admitted with a sacral fracture after conservative treatment in a trauma surgery ward for further rehabilitative treatment.

INVESTIGATIONS: At admittance the patient complaint of lower back pain. Physical examination revealed unsteadiness in walking tests. Laboratory tests revealed mildly elevated infection parameters (CRP 0.67 mg / dl) and alkaline phosphatase (191U / I).

TREATMENT AND COURSE: Physical training was initiated. Multimodal therapy for pain was continued with tilidin / naloxon, which had been started at the trauma surgery ward. Due to persistent pain and its radicular nature additional pregabaline treatment was initiated. Ten days thereafter the patient developed nausea without vomiting and subsequently (day 15) jaundice. Blood examination revealed elevated liver enzymes (ALT 246U / I, AST 86U / I, GGT 2068U / I and bilirubine 6 mg / dl). Abdominal sonography and MRCP were normal. After discontinuation of pregabaline treatment nausea disappeared within several days and liver enzymes declined to normal values within several weaks.

CONCLUSION: Pregabaline should be taken into account as cause of acute liver failure.