• Huajun Wang, Shiyi Liu, Chenjie Zhou, and Ye Fu.
• Department of Intensive Care Unit, The Affiliated People's Hospital of Ningbo University, Ningbo City, Zhejiang Province, P. R. China.
• Medicine (Baltimore). 2023 May 12; 102 (19): e33743e33743.

RationaleAtorvastatin is a commonly used statin for the treatment of hypercholesterolemia in people at high risk for coronary, cerebrovascular, and peripheral artery disease. However, fatal liver failure due to atorvastatin treatment has been rarely reported, especially during the very short incubation period.Patient ConcernsA 63-year-old male patient was admitted due to unexplained chest pain. After admission, his liver function had decreased < 24 hours after taking 20 mg tablets of atorvastatin due to lacunar infarction, which was improved after drug withdrawal. The treatment regimen was restarted 15 days later, but within 16 hours, the patient developed multiple organ failure, including liver failure and renal failure.DiagnosesThe pathological results after 7 days indicated focal inflammatory necrosis, virus and autoimmune correlation tests were negative, which did not rule out drug-induced liver injury. Interventions: receiving artificial liver therapy, continuous renal replacement therapy and other organ support treatment.OutcomesThe patient died 18 days after admission.LessonsStatin idiosyncratic liver injury is very rare, but the consequences can be serious.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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