# Acetazolamide-Induced Liver Injury: A Case Report and Literature Review

## TL;DR

This paper reports a rare case of liver injury caused by the drug acetazolamide and highlights the importance of early detection and stopping the drug.

## Contribution

The paper adds a new documented case of acetazolamide-induced liver injury to the limited existing literature.

## Key findings

- An elderly male developed severe but asymptomatic DILI after using acetazolamide.
- Rechallenge with a higher dose worsened liver enzyme elevations, supporting a causal link.
- Liver function improved after discontinuation of the drug.

## Abstract

Acetazolamide is a carbonic anhydrase inhibitor, which has been very rarely associated with drug-induced liver injury (DILI). This report presents a case of an elderly male who developed severe but asymptomatic DILI associated with acetazolamide use. Severity was established based on markedly elevated serum transaminases. Subsequent rechallenge of acetazolamide at a higher dose resulted in increased severity of the elevations, further suggesting a causative effect. Liver function tests ultimately improved after acetazolamide discontinuation. This case underscores the need for early recognition and timely discontinuation of acetazolamide to prevent worsening liver injury and optimize clinical outcomes.

Only two prior documented cases of acetazolamide-induced DILI are found in the medical literature. A detailed review and comparison of those prior cases have been undertaken in the discussion of this case presentation.