From Sedation to Injury: Isoflurane‐Associated Hepatic Dysfunction: A Series of 3 Intriguing Cases
5 affiliations
- 1A. O. Hospital Karachi Pakistan
- 2Abbasi Shaheed Hospital Karachi Pakistan
- 3Sindh Government Children Hospital Karachi Pakistan
- 4Department of Plastic Surgery Shaheed Mohtarma Benazir Bhutto Institute of Trauma Karachi Pakistan
- 5University of Dhaka Dhaka Bangladesh
Abstract
Hepatitis occurring post‐induction of general anesthesia remains a perplexing conundrum of medicine. Isoflurane, one of the most commonly employed drugs in the maintenance of anesthesia worldwide, has succeeded outdated agents such as halothane. Despite its widespread and high frequency of usage, there exist unanticipated and undesirable side effects and toxicity that are usually overlooked, as the symptoms are mostly generic and insidious. It is reported that isoflurane causes acute liver injury ranging from mild transaminitis to fulminant hepatic failure. This case series discusses patients who have been unfortunate victims of this situation, developing severe transaminitis after exposure to isoflurane during general anesthesia induction and maintenance for surgical interventions for their respective ailments in the absence of any other relevant causal links. Every patient presented with postoperative jaundice and markedly elevated liver enzymes, which were treated conservatively, resulting in full recovery. In the absence of more specific therapies, conservative management remains the cornerstone of treatment. In this article, 3 intriguing cases have been described. These cases highlight the need for more research and greater awareness of isoflurane‐induced hepatotoxicity, especially given its non‐specific presentation.
Related
- Lower circulating angiotensinogen levels across ACLD stages are associated with hepatic dysfunction and mortality
- Very low-calorie diet reduces hepatic steatosis and remodels circulating metabolite-microRNAs networks in metabolic dysfunction-associated steatotic liver disease: A pilot study
- Comparison of Metabolic Dysfunction‐Associated Steatotic Liver Disease Between Individuals With Werner Syndrome and Those With Insulin‐Resistant Type 2 Diabetes: Hepatic Steatosis and Fibrosis Indices
- Successive and Isoform-Specific Remodeling of Hepatic Drug-Metabolizing Enzymes during Metabolic Dysfunction-Associated Steatotic Liver Disease/Metabolic Dysfunction-Associated Steatohepatitis Progression
- Exercise training improves hepatic enzymes, body mass index, and cardiorespiratory fitness in adults with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis
BibTeX
@article{syed2026from,
title = {{From Sedation to Injury: Isoflurane‐Associated Hepatic Dysfunction: A Series of 3 Intriguing Cases}},
author = {Mohammad Nabeel Aamir Syed and Faina Qaiser and Fabeha Hilal Makhdoomi and Muhammad Taha Arshad Shaikh and Syeda Aisha and Tanvir Hayder},
journal = {Clinical case reports},
year = {2026},
month = nov,
doi = {10.1002/ccr3.73838},
url = {https://europepmc.org/article/PMC/PMC13725435},
note = {CC BY},
}
RIS
TY - JOUR
TI - From Sedation to Injury: Isoflurane‐Associated Hepatic Dysfunction: A Series of 3 Intriguing Cases
AU - Mohammad Nabeel Aamir Syed
AU - Faina Qaiser
AU - Fabeha Hilal Makhdoomi
AU - Muhammad Taha Arshad Shaikh
AU - Syeda Aisha
AU - Tanvir Hayder
PY - 2026
DA - 2026/11/01
JO - Clinical case reports
DO - 10.1002/ccr3.73838
UR - https://europepmc.org/article/PMC/PMC13725435
AB - Hepatitis occurring post‐induction of general anesthesia remains a perplexing conundrum of medicine. Isoflurane, one of the most commonly employed drugs in the maintenance of anesthesia worldwide, has succeeded outdated agents such as halothane. Despite its widespread and high frequency of usage, there exist unanticipated and undesirable side effects and toxicity that are usually overlooked, as the symptoms are mostly generic and insidious. It is reported that isoflurane causes acute liver injury ranging from mild transaminitis to fulminant hepatic failure. This case series discusses patients who have been unfortunate victims of this situation, developing severe transaminitis after exposure to isoflurane during general anesthesia induction and maintenance for surgical interventions for their respective ailments in the absence of any other relevant causal links. Every patient presented with postoperative jaundice and markedly elevated liver enzymes, which were treated conservatively, resulting in full recovery. In the absence of more specific therapies, conservative management remains the cornerstone of treatment. In this article, 3 intriguing cases have been described. These cases highlight the need for more research and greater awareness of isoflurane‐induced hepatotoxicity, especially given its non‐specific presentation.
SN - 2050-0904
ER -