Nicotinamide as a Cause of Severe Acute Hepatocellular Injury
- 1Gastroenterology, Monash Health, Melbourne, Victoria, Australia
- 2College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- 3Emergency Medicine, Monash Health, Melbourne, Victoria, Australia
Abstract
Dietary supplements are widely perceived as safe, yet high-dose ingestion can cause severe toxicity. We report a 20-year-old woman who developed acute hepatocellular injury following intentional ingestion of 15 g nicotinamide. She presented with vomiting, epigastric pain, and transient hypotension. Liver function tests rapidly deteriorated with a marked transaminitis, with associated coagulopathy. There was no hepatic encephalopathy. Extensive investigations for viral, autoimmune, metabolic, and vascular causes were unrevealing. She improved with supportive care, including N-acetylcysteine, vitamin K, and electrolyte replacement. This case highlights nicotinamide overdose as an important and potentially under-recognized cause of severe acute liver injury.
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BibTeX
@article{hakimi2026nicotinamide,
title = {{Nicotinamide as a Cause of Severe Acute Hepatocellular Injury}},
author = {Yousef Hakimi and Stefan Uzelac and Nicholas Wan and Natalie Yu and Nikita Parkash and Matthew Brownlow and Dilip Ratnam},
journal = {ACG Case Reports Journal},
year = {2026},
month = nov,
doi = {10.14309/crj.0000000000002365},
url = {https://doi.org/10.14309/crj.0000000000002365},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Nicotinamide as a Cause of Severe Acute Hepatocellular Injury
AU - Yousef Hakimi
AU - Stefan Uzelac
AU - Nicholas Wan
AU - Natalie Yu
AU - Nikita Parkash
AU - Matthew Brownlow
AU - Dilip Ratnam
PY - 2026
DA - 2026/11/04
JO - ACG Case Reports Journal
DO - 10.14309/crj.0000000000002365
UR - https://doi.org/10.14309/crj.0000000000002365
AB - Dietary supplements are widely perceived as safe, yet high-dose ingestion can cause severe toxicity. We report a 20-year-old woman who developed acute hepatocellular injury following intentional ingestion of 15 g nicotinamide. She presented with vomiting, epigastric pain, and transient hypotension. Liver function tests rapidly deteriorated with a marked transaminitis, with associated coagulopathy. There was no hepatic encephalopathy. Extensive investigations for viral, autoimmune, metabolic, and vascular causes were unrevealing. She improved with supportive care, including N-acetylcysteine, vitamin K, and electrolyte replacement. This case highlights nicotinamide overdose as an important and potentially under-recognized cause of severe acute liver injury.
SN - 2326-3253
ER -