Fulminant hepatic failure in association with quetiapine: case report and literature review

Fulminant hepatic failure is a serious disease with significant mortality and morbidity. Identifying the cause of fulminant hepatic failure in managing these patients and predicting the outcome. Drug induced liver injury is a common but challenging entity. New medications and drugs with recently discovered hepatotoxicity require the clinician’s careful attention. Quetiapine is an antipsychotic that has been linked to liver toxicity in very few case reports. In this report we describe a case of fulminant hepatic failure secondary to quetiapine. A 59 years old Caucasian female with history of Parkinson's disease was treated with quetiapine for hallucinations. Althoihe presented to our hospital with jaundice and developed hepatic encephalopathy. The diagnosis of fulminant liver failure was made and she required admission to the intensive care unit . Her condition improved after discontinuing the offending agent and providing supportive treatment. This case stresses the importance of keeping an open mind in cases of fulminant liver failure. Consideration should be given to drug induced liver injury as the potential cause. The patient’s list of medications needs to be reviewed carefully.