{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:46:37Z","timestamp":1783979197843,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,9,12]]},"abstract":"<jats:p>Hypoxic hepatitis is a rather common complication of heart, circulatory or respiratory failure. We present the case of a patient with hypoxic hepatitis in the setting of heart failure and dehydration from furosemide as a reminder of an important clinical lesson. The pathogenesis of hypoxia (especially in the case of heart failure) is explained by a two-hit mechanism in which the liver at risk of hypoxic injury by passive hepatic congestion (right heart failure) is subsequently exposed to systemic hypoperfusion, which leads to a marked and transient elevation of aminotransferases. In the case presented, the use of furosemide (at least partially) promoted the second hit because it helped to generate hypotension and splanchnic hypovolaemia and favoured hepatic hypoxia.<\/jats:p>","DOI":"10.1136\/bcr-2018-225497","type":"journal-article","created":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T01:05:19Z","timestamp":1538355919000},"page":"bcr-2018-225497","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Hypoxic hepatitis and furosemide"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5449-9124","authenticated-orcid":false,"given":"Ana Carina","family":"Pizzarossa","sequence":"first","affiliation":[{"name":"Cl\u00ednica M\u00e9dica C, Hospital de Cl\u00ednicas, Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart\u00edn","family":"Rebella","sequence":"additional","affiliation":[{"name":"Cl\u00ednica M\u00e9dica C, Hospital de Cl\u00ednicas, Montevideo, Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,9,30]]},"reference":[{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2011.02655.x"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.46.0059"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.3","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.amjmed.2015.07.033","article-title":"The incidence and outcomes of ischemic hepatitis: a systematic review with meta-analysis","volume":"128","author":"Tapper","year":"2015","journal-title":"Am J Med"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000101573.54295.bd"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-010-1058-3"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1508-2"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.7","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1097\/MOG.0000000000000355","article-title":"Current concepts in ischemic hepatitis","volume":"33","author":"Lightsey","year":"2017","journal-title":"Curr Opin Gastroenterol"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.8","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1097\/00004836-199612000-00016","article-title":"Ischemic hepatitis: the need for precise criteria","volume":"23","author":"Henrion","year":"1996","journal-title":"J Clin Gastroenterol"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.9","first-page":"813","article-title":"Hepatitis y furosemida","volume":"88","author":"Bellido Casado","year":"1996","journal-title":"Rev Esp Enf Dig"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.10","doi-asserted-by":"crossref","first-page":"845","DOI":"10.7326\/0003-4819-109-10-845","article-title":"Furosemide and increases in liver enzymes","volume":"109","author":"Lang","year":"1988","journal-title":"Ann Intern Med"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.11","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.76"},{"key":"2025082801554235000_2018.sep29_1.bcr-2018-225497.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-011-1918-1"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:55:48Z","timestamp":1756371348000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,30]]},"references-count":12,"alternative-id":["10.1136\/bcr-2018-225497"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225497","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,30]]}}}