Clinical Characteristics of Patients with Drug-induced Liver Injury

• Published in: Chinese medical journal 2017-01, Vol.130 (2), p.160-164
• Main Authors: Yang, Li-Xia, Liu, Cheng-Yuan, Zhang, Lun-Li, Lai, Ling-Ling, Fang, Ming, Zhang, Chong
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis; Anti-Bacterial Agents - adverse effects; Antithyroid Agents - adverse effects; Antitubercular Agents - adverse effects; Bile; Chemical and Drug Induced Liver Injury - diagnosis; Chemical and Drug Induced Liver Injury - etiology; Child; China; Clinical Characteristics; Drug-induced Liver Injury; Pathology; Complications and side effects; Drug dosages; Drugs; Drugs, Chinese Herbal - adverse effects; Female; Gallbladder diseases; Gangrene; Health aspects; Hepatitis; Hospitals; Humans; Infectious diseases; Inflammation; Liver - drug effects; Liver diseases; Male; Medical diagnosis; Metabolism; Middle Aged; Original; Patient education; Retrospective Studies; Statistical analysis; Young Adult; 中草药; 临床特点; 安全信息; 抗结核药物; 病理特点; 肝损伤; 药物性; 西方医学
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.197995

Background： Drug is all important cause of liver injury and accounts for up to 40% of instances offidminant hepatic failure. Drug-induced liver injury （DILl） is increasing while the diagnosis becomes more difficult. Though many drugs may cause DILl, Chinese herbal medicines have recently emerged as a major cause due to their extensive use in China. We aimed to provide drug safety information to patients and health carets by analyzing the clinical and pathological characteristics of the DILl and the associated drug types. Methods： A retrospective analysis was conducted in 287 patients diagnosed with DILl enrolled in our hospital from January 2011 to December 2015. The categories of causative drugs, clinical and pathological characteristics were reviewed. Results： Western medicines ranked as the top cause of DILl, accounting for 163 out of the 287 DILl patients （56.79%） in our study. Among the Western medicine, antituberculosis drugs were the highest cause （18.47%, 53 patients） of DILl. Antibiotics （18 patients, 6.27%） and antithyroid （18 patients, 6.27%） drugs also ranked among the major causes of DILl. Chinese herbal medicines are another major cause of DILl, accounting for 36.59% of cases （105 patients）. Most of the causative Chinese herbal medicines were those used to treat osteopathy, arthropathy, dermatosis, gastropathy, leukotrichia, alopecia, and gynecologic diseases. Hepatocellular hepatitis was prevalent in DILl, regardless of Chinese herbal medicine or Western medicine-induced DILI. Conclusions： Risks and the rational use of medicines should be made clear to reduce the occurrence of DILl. For patients with liver injury of unknown origin, liver tissue pathological examination is recommended for further diagnosis.