# Statin-Induced Hyper-Acute Reversible Liver Failure: A Case Report

## TL;DR

A 70-year-old man experienced severe liver failure within a day of starting high-dose atorvastatin, highlighting the rare but serious risk of statin-induced liver injury.

## Contribution

This case report documents a rare instance of hyperacute liver failure caused by high-dose atorvastatin in an elderly patient.

## Key findings

- The patient developed severe liver failure within 24 hours of starting atorvastatin 80 mg.
- His condition improved rapidly after discontinuing the drug, pointing to drug-induced liver injury.
- The case underscores the need for caution with high-dose statins in elderly patients with comorbidities.

## Abstract

Statins, particularly high-dose atorvastatin, are widely used for cardiovascular prevention but can rarely cause severe hepatotoxicity. We report a case of a male in his seventies who developed hyperacute hepatic failure within 24 hours of initiating atorvastatin 80 mg for secondary stroke prevention. Extensive investigations ruled out alternative causes, and his condition rapidly improved after discontinuation, implicating drug-induced liver injury. This case highlights the unpredictable nature of statin-induced hepatotoxicity, emphasizing the need for vigilance, particularly in elderly patients with comorbidities. Further research is needed to guide safe reintroduction strategies and alternative lipid-lowering options for affected individuals.