Methylphenidate (MPH) is a widely prescribed psychostimulant for the management of attention deficit hyperactivity disorder (ADHD). Although most adverse effects of MPH are transient and reversible, hepatotoxicity remains a rare but potentially serious complication. We present the case of a 12-year-old female patient with ADHD who had been receiving MPH treatment since the age of 8. After three and a half years of therapy, she did blood tests that showed a marked elevation in transaminases and gamma-glutamyl transferase. Extensive evaluation ruled out alternative causes of liver disease, and liver biopsy findings were consistent with drug-induced hepatitis. Discontinuation of MPH resulted in progressive normalization of liver enzyme levels. This case underscores the importance of regular laboratory monitoring during long-term psychostimulant therapy, particularly regarding liver function. Early recognition of abnormal biochemical findings allows for prompt discontinuation of the offending drug, reversal of hepatic injury, and prevention of more severe complications such as liver failure.

Click here for the full paper