Topical Diclofenac-Induced Hepatotoxicity

The hepatotoxic potential of diclofenac, a commonly used non-steroidal antiinflammatory agent, is well established in literature. However, cases diclofenacinduced liver disease have occurred almost exclusively with the oral formulation this medication. We report case an elderly man Paget’s and osteoarthritis who developed acute hepatotoxicity, as evidenced by laboratory diagnostics, four months after use topical diclofenac 1% gel. Once gel was discontinued, repeat blood work three weeks discharge demonstrated return function tests to baseline. Given temporal relationship between initiation escalation changes tests, likelihood diclofenac-induced injury deemed possible using wellrecognized causality assessment tool. Further research on topically administered nonsteroidal anti-inflammatory agents needed identify monitoring intervals for early detection avoidance adverse effects patients diclofenac.