Alpha-methyldopa hepatotoxicity in pregnancy

12-week pregnant, 33-year-old African American female, presented with jaundice and change in urine colour. Liver function tests revealed raised transamines and normal alkaline phosphatase. She was started on methyldopa 6 weeks prior to presentation. After initial negative investigations including viral and autoimmune hepatitis, she was given prednisone for methyldopa induced hepatitis. Two weeks later, repeat enzymes revealed normal values. Important clinical and management points related to methyldopa induced hepatotoxicity are discussed