Drug-Induced Hepatitis Caused by Methylphenidate: A Case Report

Methylphenidate (MPH) is a widely prescribed psychostimulant for the management of attention deficit hyperactivity disorder (ADHD). Although most adverse effects of MPH are transient and reversible, hepatotoxicity remains a rare but potentially serious complication. We present the case of a 12-year-old female patient with ADHD who had been receiving MPH treatment since the age of 8. After three and a half years of therapy, she did blood tests that showed a marked elevation in transaminases and gamma-glutamyl transferase. Extensive evaluation ruled out alternative causes of liver disease, and liver biopsy findings were consistent with drug-induced hepatitis. Discontinuation of MPH resulted in progressive normalization of liver enzyme levels. This case underscores the importance of regular laboratory monitoring during long-term psychostimulant therapy, particularly regarding liver function. Early recognition of abnormal biochemical findings allows for prompt discontinuation of the offending drug, reversal of hepatic injury, and prevention of more severe complications such as liver failure.

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Publication Details

Journal
Acta Médica Portuguesa
Published
2025-12-17
DOI
https://doi.org/10.20344/amp.23703
Primary Topic
Attention Deficit Hyperactivity Disorder
Type
article
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article

Drug-Induced Hepatitis Caused by Methylphenidate: A Case Report

Sandra Roberta G. Ferreira, Mónica Bravo, Sónia Almeida, Sandra Rebimbas
Acta Médica Portuguesa
Attention Deficit Hyperactivity Disorder
article

Drug-Induced Hepatitis Caused by Methylphenidate: A Case Report

Sandra Roberta G. Ferreira, Mónica Bravo, Sónia Almeida, Sandra Rebimbas
article en

Abstract

Methylphenidate (MPH) is a widely prescribed psychostimulant for the management of attention deficit hyperactivity disorder (ADHD). Although most adverse effects of MPH are transient and reversible, hepatotoxicity remains a rare but potentially serious complication. We present the case of a 12-year-old female patient with ADHD who had been receiving MPH treatment since the age of 8. After three and a half years of therapy, she did blood tests that showed a marked elevation in transaminases and gamma-glutamyl transferase. Extensive evaluation ruled out alternative causes of liver disease, and liver biopsy findings were consistent with drug-induced hepatitis. Discontinuation of MPH resulted in progressive normalization of liver enzyme levels. This case underscores the importance of regular laboratory monitoring during long-term psychostimulant therapy, particularly regarding liver function. Early recognition of abnormal biochemical findings allows for prompt discontinuation of the offending drug, reversal of hepatic injury, and prevention of more severe complications such as liver failure.

Acta Médica Portuguesa
Escola Superior de Tecnologia da Saúde de Coimbra (PT), Administração Regional de Saúde de Lisboa e Vale do Tejo (PT), University of Aveiro (PT)
Openalex Percentile: Top 52%
Attention Deficit Hyperactivity Disorder
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