Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic.
BACKGROUND
Limited data exist on the proportion of drug-induced liver injury among out-patients seen in a hepatology clinic.


OBJECTIVE
To determine the proportion of drug-induced liver injury cases, and identify the most important agents and the nature of the liver injury.


METHODS
A computerized diagnoses database in an out-patient hepatology clinic in a Swedish University hospital was analysed during the period 1995-2005. All suspected drug-induced liver injury cases were causality assessed with the International Consensus Criteria.


RESULTS
A total of 1164 cases were seen for the first time during this period. Drug-induced liver injury with at least a possible causal relationship was found in 77 cases (6.6%), 38 (3.3%) of whom were referred for evaluation to the out-patient clinic whereas 3% had a follow-up after hospitalization of drug-induced liver injury. The median age was 58 years, 43 (56%) were females, a hepatocellular pattern was observed in 37 cases (48%), cholestatic in 31 (40%) and mixed in 12%. Antibiotics were the most common agents causing drug-induced liver injury followed by non-steroidal anti-inflammatory drugs, with diclofenac most often responsible for the drug-induced liver injury.


CONCLUSIONS
Drug-induced liver injury cases constituted 6% of all out-patients and 3% of referrals and occurred more often in women. Antibiotics and diclofenac were the most common causes of drug-induced liver injury among out-patients.
De Valle
M B
MB
Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
Av Klinteberg
V
V
Alem
N
N
Olsson
R
R
Björnsson
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury; D005234:Fatty Liver / Q000139:chemically induced; D005260:Female; D006526:Hepatitis C / Q000139:chemically induced; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000209:etiology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal