Cholestasic toxic hepatitis due to clopidogrel in a patient with multiple conditions

Clopidogrel is a thienopyridine-class antiplatelet drug commonly used in ischemic heart disease, cerebrovascular disease and peripheral artery disease. Liver toxicity due to this drug is very infrequent. We found 16 cases in the literature, and in only two of them liver biopsy was carried out. We report the case of a 78 year old patient with multiple conditions affected by severe toxic cholestatic hepatitis due to clopidogrel and the results of the liver biopsy performed. Hepatitis was resolved after discontinuing the drug. Based on the characteristics of this case and other previously published cases, we review the characteristics of toxic hepatitis due to clopidogrel and its diagnosis and treatment.