Outcome of acute idiosyncratic drug‐induced liver injury: Long‐term follow‐up in a hepatotoxicity registry

  title={Outcome of acute idiosyncratic drug‐induced liver injury: Long‐term follow‐up in a hepatotoxicity registry},
  author={Ra{\'u}l Jes{\'u}s Andrade and M. Isabel Lucena and Neil Kaplowitz and Beatriz Garc{\'i}a-Muņoz and Yolanda Borraz and Ketevan Pachkoria and Miren Garc{\'i}a‐Cort{\'e}s and M. Carmen Fern{\'a}ndez and Gloria Pelaez and Luis Rodrigo and Jos{\'e} Ant{\'o}nio Duran and Joan Costa and Ramón Planas and Anabel Barriocanal and Carlos Guarner and Manuel Romero-G{\'o}mez and Teresa Muñoz-Yagüe and Javier Salmerón and Ram{\'o}n Hidalgo},
A chronic adverse reaction may occur in some instances of drug‐induced liver injury (DILI), even despite drug cessation. In our study, we obtained records from a Spanish registry and evaluated cases of DILI with biochemical evidence of long‐term damage. Chronic outcome was defined as a persistent biochemical abnormality of hepatocellular pattern of damage more than 3 months after drug withdrawal or more than 6 months after cholestatic/mixed damage. Data on 28 patients with a chronic clinical… 
Idiosyncratic drug-induced liver injury: an overview
Over the next decade, the combination of accurate case ascertainment of DILI via clinical networks and the application of genomics and proteomics will hopefully lead to accurate prediction of risk of D ILI, so that pharmacotherapy can be optimised with avoidance of adverse hepatic events.
Idiosyncratic drug-induced liver injury is associated with substantial morbidity and mortality within 6 months from onset.
The profile of liver injury at presentation, initial severity, patient's race, and medical comorbidities are important determinants of the likelihood of death/transplantation or persistent liver injury within 6 months of DILI onset.
The diagnosis and management of idiosyncratic drug‐induced liver injury
  • Ammar HassanR. Fontana
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2019
A number of promising diagnostic, prognostic and mechanistic serum and genetic biomarkers may help improve the understanding of the pathogenesis and treatment of idiosyncratic DILI.
Assessment of Serious Acute and Chronic Idiosyncratic Drug-Induced Liver Injury in Clinical Practice.
Risk factors for chronicity, specific phenotypes, and histological features are discussed in this study and prognostic scoring algorithms for the early identification of DILI patients who may go on to develop ALF have been developed.
Drug-Induced Liver Injury: Highlights from a Review of the 2015 Literature
New DILI biomarkers, specifically microRNA-122 and keratin-18, appear to have the necessary predictive value to determine the prognosis and outcome of patients with paracetamol-induced acute liver failure (ALF), and may be of great benefit in deciding who requires N-acetylcysteine (NAC), and for what duration.
Drug-induced liver disease in 2006
Drug-induced liver injury remains an important concern for many existing drugs as well as for agents in development and new reports appeared with highly active antiretroviral therapy agents, herbal therapies and several antibiotics.


Outcome and prognostic markers in severe drug‐induced liver disease
Age, aspartate aminotransferase (AST) and bilirubin were found to independently predict death or liver transplantation in the hepatocellular group, whereas among patients with cholestatic/mixed liver injury, bilirUBin was the only independent predictor.
The natural history of histologically proved drug induced liver disease
Drugs should be considered in the differential diagnosis of abnormal liver function and/or histology, as failure to withdraw the offending drug is associated with a high risk of persistent liver damage.
Liver transplantation for acute liver failure from drug induced liver injury in the United States
Four drugs were implicated in 42% of patients undergoing liver transplants for acute liver failure due to drugs other than APAP, and the increased frequency of African‐American women undergoing liver transplantation for non‐APAP drug induced liver injury warrants further study.
Results of a Prospective Study of Acute Liver Failure at 17 Tertiary Care Centers in the United States
The primary aim was to compare presenting clinical features and liver transplantation in patients with acute liver failure related to acetaminophen hepatotoxicity, other drugs, indeterminate factors, and other causes.
Liver cirrhosis induced by long-term administration of a daily low dose of amiodarone: a case report.
An autopsy case of AD-induced liver cirrhosis in a patient who had been treated with a low dose of AD (200 mg/d) daily for 84 mo and died from complications of pneumonia and renal failure is presented.
HLA class II genotype influences the type of liver injury in drug‐induced idiosyncratic liver disease
There is no association between any specific HLA allele and the propensity to develop DIILD, however, the genetic influence associated with HLA class II alleles appears to play a role in the biochemical expression of liver injury in cholestatic/mixed hepatotoxicity and may explain why a given drug may cause different patterns of liver damage.
United states.
  • V. Caron
  • Medicine
    Nursing standard (Royal College of Nursing (Great Britain) : 1987)
  • 1988
The Association of Operating Room Nurses has stood behind other US nursing organisations in condemning the idea of introducing a registered care technologist to cope with nursing shortages.