Drug Induced Liver Injury and Lactic Acidosis Associated with Chronic Sustained Release Nicotinamide Exposure | Biomedgrid

It is frequently difficult to identify an etiology in an individual case of acute liver injury. Xenobiotic exposures, infectious causes, and a broad differential of other potential contributors need to be considered. Pinpointing the specific cause of a patient's liver injury helps to guide management, especially when xenobiotics are implicated, by indicating potential therapeutic interventions and by avoidance of recurrent injury from inadvertent re-challenge with an offending agent. We present a case of acute liver failure presenting with concomitant metabolic lactic acidosis and hypoglycemia associated with the therapeutic dosing of sustained-release niacin, confirmed by laboratory testing