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Drug-Induced Liver Injury

Leise, Michael D., Poterucha, John J., Talwalkar, Jayant A.·2014·Mayo Clinic Proceedings
DOI 10.1016/j.mayocp.2013.09.016
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Abstract

Drug hepatoxicity can be nonidiosyncratic (predictable), as in the case of acetaminophen, or idiosyncratic (unpredictable). This review article focuses primarily on idiosyncratic drug-induced liver injury (DILI). New epidemiologic data suggest that approximately 20 new cases of DILI per 100,000 persons occur each year. Idiosyncratic DILI accounts for 11% of the cases of acute liver failure in the United States. Risk factors for DILI include medication dose, drug lipophilicity, and extent of hepatic metabolism. There is mixed evidence to support the role of host factors such as age, sex, and chronic liver disease in the development of DILI. For specific drugs, a genetic predisposition appears to be a risk factor for DILI. Suspected cases of idiosyncratic DILI should be categorized as hepatitic, cholestatic, or mixed on the basis of the degree/ratio of abnormalities in the alanine aminotransferase and alkaline phosphatase. A careful evaluation for other causes of liver disease should be performed, though a liver biopsy is rarely needed. There is evidence that some patients with DILI may actually have hepatitis E and this diagnosis should be considered. Amoxicillin/clavulanate isoniazid, and nonsteroidal anti-inflammatory drugs are among the most common causes of DILI. Drug discontinuation or dechallenge should lead to an improvement in liver biochemistries in most patients, though a bilirubin value of more than 3 g/dL is associated with mortality of at least 10%. New biomarkers…

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Crossref · 10.1016/j.mayocp.2013.09.016

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  • Across various registries, the most common causative drugs for DILI were anti-infectious agents, anti-TB drugs, and natural herbal medicines.

    “Also, the most common causative drugs were anti-infectious agents, anti-TB drugs and natural herbal medicines across various registries.”

    From Incidence and Etiology of Drug-Induced Liver Injury in Mainland China (2019) · cites this paper as [11]

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Metadata

Authors
Leise, M. D., Poterucha, J. J., & Talwalkar, J. A.
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
2014-01
Volume
89
Issue
1
Pages
95-106
ISSN
0025-6196
DOI
10.1016/j.mayocp.2013.09.016
Cited by
356
References
5
Language
en
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)

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