03 February 2026
: Case report 
Drug-Induced Liver Injury Associated With the Angiotensin II Receptor Blocker Losartan in a 59-Year-Old Woman With Hypertension: A Case Report
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy
Ahmad Al-Ajaj
BDE 1*, Wissem Melki E 1
DOI: 10.12659/AJCR.949256
Am J Case Rep 2026; 27:e949256
Table 2 Liver enzyme trends before and after discontinuation of losartan.
| Liver function test | ALT | AST | PT/INR | ALP | Bilirubin |
|---|---|---|---|---|---|
| Initial liver function tests | 640 IU/L | 341 IU/L | PT, 12 s (11–13.5 s); INR, 1.0 (08–1.2) | 247 IU/L | TBili, 8.8 μmol/L; DBili, 3.0 μmol/L. |
| Liver enzymes after 2 weeks | 533 IU/L | 224 IU/L | 334 IU/L | TBili, 8.7 umol/L; DBili, 3.3 mmol/L | |
| Liver enzymes after 2 months | 494 IU/L | 255 IU/L | 279 IU/L | TBili, 8.0 umol/L; DBili, 4.3 umol/L | |
| Liver enzymes after 6 months (1 month after losartan discontinuation) | 29 IU/L | 22 IU/L | 102 IU/L | TBili, 5.5 umol/L; DBili, 2.2 mmol/L | |
| Liver enzymes 4 month after losartan discontinuation | 26 IU/L | 21 IU/L | 100 IU/L | TBili, 5.0 umol/L; DBili, 1.1 mmol/L | |
| ALT – alanine aminotransferase; AST – aspartate aminotransferase; ALP – alkaline phosphatase; PT – prothrombin time; INR – international normalized ratio; DBili – direct bilirubin; TBili – total bilirubin. | |||||