Patient and procedure

Total dose/duration of propofol

Liver enzymes evaluation

Investigations

Treatment and outcome

Anand et al^[2]

17F, 56.8kg, unilateral femoral hernia repair

682mg

AST 1423 U/L (around 25-30 times normal) with an ALT of 1567 U/L (around 30 times of normal limits)

USG liver normal

Resolved spontaneously with supportive measures

Polo-Romerio et al^[3]

66 M, ERCP

Brief sedation

AST and ALT 50 times greater than normal level

USG and CT abdomen normal

Resolved spontaneously with supportive measures

Nguyen et al^[4]

62F, colonoscopy

250mg

AST 77 times greater than normal upper limit; ALT 44 times exceeds normal limits

Bx: hepatitis with severe activity and mild to focally moderate fibrosis, likely for toxin or drug reaction

Resolved spontaneously with supportive measures after liver biopsy

Kneiseler et al^[5]

35F, unilateral stripping of varicose veins

540mg

Four- to sixfold elevated transaminases with impaired coagulation and jaundice

Bx: hepatocyte death and microvesicular fatty

degeneration of 90% of the liver parenchyma

Daily IV prednisolone 250 mg, tapered to 40 mg while patient’s condition improved rapidly. LFT normalized one year

Asai et al^[6]

75F, 36kg, electroconvulsive therapy

Brief

AST 4684 U/L; ALT 3246 U/L; ALP 632 U/L,

Bx: mild lyphocytic infiltration of portal tracts,

Positive drug lymphocyte-stimulation testing (DLST)

Glycyrrhizin 60ml/day, LFT normalized day 60 after treatment

O’Shea et al. ^[7]

33M with pontine haemorrhage, induction and post-intubation sedation

150mg for induction; 5 mcg/kg/min for 1 day

ALT 656 U/L; AST 240 U/L; ALP 174 U/L

USG unremarkable

LFT returned to normal levels after propofol infusion was stopped