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12 August 2021: Articles

Hepatotoxicity Induced by Fluvastatin: A Reversible Acute Cholestatic Liver Injury

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy

Najah S. Alanazi A , Tahani S. Alenazi A , Khalidah A. Alenzi A*

DOI: 10.12659/AJCR.931418

Am J Case Rep 2021; 22:e931418

Table 2. Naranjo Causality Scale for adverse drug reactions.

FluvastatinMetforminGliclazide
NoQuestion/Scoring Yes/No/Do Not Know Or UnavailableYesNoNAYesNoNAYesNoNA
1Are there previous conclusive reports on this reaction? 1/0/0+1+1+1
2Did the adverse event appear after the suspected drug was given? 2/−1/0+2−1−1
3Did the adverse reaction improve when the drug was discontinued or a specific antagonist was given? 1/0/0+1+1+1
4Did the adverse reaction reappear when the drug was readministered? 2/−1/0000
5Are there alternative causes that could have caused the reaction? −1/2/0+2+2+2
6Did the reaction reappear when a placebo was given? −1/1/0000
7Was the drug detected in any body fluid in toxic concentrations? 1/0/0000
8Was the reaction more severe when the dose was increased, or less severe when the dose was decreased? 1/0/0000
9Did the patient have a similar reaction to the same or similar drugs in any previous exposure? 1/0/0000
10Was the adverse event confirmed by any objective evidence?+1+1+1
Scoring >9 – highly probable ADR; 5–8 – probable ADR; 1-4 – possible ADR; 0 – unlikely ADR.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923