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Idiosyncratic Drug-Induced Liver Injury Associated With and Without Drug Reaction With Eosinophilia and Systemic Symptoms
Abstract
INTRODUCTION: Immunoallergic drug-induced liver injury (DILI) presenting with features of drug reaction with eosinophilia and systemic symptoms (DRESS) is a distinct phenotype. We describe the clinical characteristics, hepatitis pattern, severity, complications, and implicated medications in DILI patients with and without DRESS. METHODS: Using established criteria, we analyzed DILI registry patients with and without DRESS from 1998 to 2021. RESULTS: DILI associated with DRESS (DwD) comprised 179 among 943 cases (19%) of DILI. Compared with the cohort without DRESS, patients with DwD are more often women and have shorter latency, lesser degrees of injury ( P < 0.01), and lower mortality (7.8%) than those without DRESS (16%). Antiepileptic drugs (36%), sulfonamides (19%), antituberculosis drugs (14%), antibiotics (10%), and antiretroviral drugs (8%) account for 87% of the cases of DwD. DISCUSSION: A limited number of drugs cause DwD, representing a fifth of patients with DILI. DwD is characterized by lesser degrees of liver injury and mortality likely because of earlier presentation.
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Patients with specific phenotypes such as eosinophilia and systemic symptoms (DRESS syndrome) may present with various symptoms such as fever, rash, and other extrahepatic symptoms.
“Patients with specific phenotypes such as eosinophilia and systemic symptoms (DRESS syndrome) may present with various symptoms such as fever, rash, and other extrahepatic symptoms [49,50].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [49]
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Sorted by citations
Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update
Mao, Y., Ma, S., Liu, C., Liu, X., Su, M., Li, D., Li, Y., Chen, G., Chen, J., Chen, J., et al. (2024) · Hepatology International · doi:10.1007/s12072-023-10633-7 · Cited by 62
Metadata
- Authors
- Devarbhavi, H., Kurien, S. S., Raj, S., Patil, M., Gowda, V., Kothari, K., & Singh, R.
- Venue
- American Journal of Gastroenterology
- Published
- 2022-07-21
- Volume
- 117
- Issue
- 10
- Pages
- 1709-1713
- ISSN
- 0002-9270
- 1572-0241
- Cited by
- 10
- References
- 0
- Language
- en
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