Hepatitis Aguda por Haloperidol

Abstract

Acute liver disease is liver inflammation acute onset of any pathological noxa. (1) The etiology of hepatotoxic agents is multiple, we include viral, bacterial, parasitic agents hepatotropic, autoimmune mechanisms, alcohol and substance abuse and multiple drugs, among them are psychoactive drugs with hepatic metabolism viral agents, capable of generating toxicity, a clear example is the Haloperidol, which in its structure has a heptanoic acid side chain, b- metabolized by oxidation, and converted by cytochrome P-450 in reactive metabolites which can induce a hypersensitivity reaction in genetically susceptible individuals. (2) The detailed medical history is essential for diagnosis and etiology. (1) (3) will be necessary to inquire about history, drug consumption, the evolution of present illness and physical examination will lead us to a presumptive diagnosis, resulting in relevant order additional tests to the suspected diagnosis. In our case we have a patient presenting with acute clinical liver disease with the only precedent Paranoid Schizophrenia treatment for 5 months with Haloperidol decanoate monthly deposit. Syndromic grouping is made, obtaining several presumptive diagnoses; complementary tests show a blood count without leukocytosis or alteration of the differential formula, elevated transaminases, hyperbilirubinemia at the expense of direct with cholestatic pattern, EMO indicating the high presence of bilirubin and upper abdominal ultrasound reports hepatomegaly consistent with acute hepatitis. With these findings hepatotropic viral markers and serological markers autoimmune negative result are investigated. By not relate to any other agent, acute hepatitis caused by Haloperidol is diagnosed, so the drug is discontinued, prior authorization of Psychiatry. With favorable evolution is discharged to the patient and the psychotropic drug is replaced with Risperidone in drops with favorable evolution. One of the problems in the diagnosis delay was the lack of reagents laboratory tests in the health unit, which generated extra costs to patients and their families, plus the absence of a diagnostic and therapeutic guide of acute liver disease within the unit health or Ministry of health websites.