Abdulaziz A AlTurki, Khaled AlQahtani, Abdulkreem A Alnasser, Meshal M AlTalha, Ali Saleh Alhamdan
Statins, particularly high-dose atorvastatin, are widely used for cardiovascular prevention but can rarely cause severe hepatotoxicity. We report a case of a male in his seventies who developed hyperacute hepatic failure within 24 hours of initiating atorvastatin 80 mg for secondary stroke prevention. Extensive investigations ruled out alternative causes, and his condition rapidly improved after discontinuation, implicating drug-induced liver injury. This case highlights the unpredictable nature of statin-induced hepatotoxicity, emphasizing the need for vigilance, particularly in elderly patients with comorbidities. Further research is needed to guide safe reintroduction strategies and alternative lipid-lowering options for affected individuals.