A 28-year-old female developed abdominal pain about 4 hours after taking levonorgestrel tablets 3 mg for emergency contraception. Thirteen days later, the patient developed yellowish discoloration of skin and sclera, with dark urine, nausea, vomiting, and fatigue. Laboratory examination showed the following levels: aspartate aminotransferase (AST) 3 586 U/L, alanine aminotransferase (ALT) 2 478U/L, total bilirubin (TBil) 101.6 μmol/L, direct bilirubin (DBil) 65.1 μmol/L. The patient was diagnosed with acute liver injury. She was treated with liver-protective drugs such as intravenous infusions of magnesium isoglycyrrhizinate, reduced glutathione, ademetionine 1, 4-butanedisulfonate, Xueshuantong (血栓通) injection, and oral ursodeoxycholic acid capsules. After 5 days, the symptoms of the patient were significantly improved, liver function tests showed the following results: ALT 902 U/L, AST 80 U/L, TBil 46.7 μmol/L and DBil 30.8 μmol/L. After 15 days, the levels of ALT, AST, and TBil were 41 U/L, 36 U/L, and 20.9 μmol/L.

Levonorgestrel; Acute liver injury