Haloperidol-induced liver injury in pregnancy: A rare case report and review of drug-induced hepatitis

Abstract

Haloperidol, a first-generation antipsychotic, is occasionally prescribed during pregnancy for the management of schizophrenia, but its hepatic safety profile is not well established, and drug-induced liver injury (DILI) remains a rare yet potentially serious complication. We report a 38-year-old pregnant woman at 14 weeks of gestation with a 3-year history of schizophrenia on Haloperidol who presented with progressive abdominal discomfort and jaundice. Laboratory evaluation demonstrated a hepatocellular pattern of liver injury with elevated AST and ALT and hyperbilirubinemia, while white blood cell count was normal. Abdominal ultrasound confirmed normal hepatobiliary anatomy without obstruction or focal lesions. Haloperidol was discontinued and replaced with Chlorpromazine, leading to normalization of liver function within 1 month and favorable maternal and fetal outcomes. This case highlights the diagnostic challenges of idiosyncratic DILI during pregnancy and underscores the importance of regular liver function monitoring in patients on long-term antipsychotics, as well as careful multidisciplinary management when hepatic adverse effects occur.