[An analysis of the causes, characteristics, and consequences of reexposure to a drug or compound responsible for a hepatotoxicity event].
BACKGROUND
reexposure to a causal agent represents a potentially serious event in hepatotoxicity.


OBJECTIVE
to assess the characteristics and outcome of cases with positive reexposure.


METHODS
a retrospective study of cases with evidence of positive reexposure included in Registro Español de Hepatopatías Asociadas a Medicamentos, and an analysis of their relation to demographic and clinical variables, causality, course, and consequences.


RESULTS
of a total of 520 cases 31 (6%) met reexposure criteria. Fatal outcomes, needs for admission, and mean recovery time were all higher for hepatocellular-type toxic injury. The most commonly identified drug class was antibiotics. On most occasions (73%) reexposure to the causal compound escaped notice because of: absence of index case diagnosis, lack of information to patients and their physicians, and (12%) development of cross reactions between structurally similar drugs.


CONCLUSIONS
accidental reexposure to a drug or a structurally-related compound after an initial hepatotoxicity event is common and may have serious consequences, particularly in hepatocellular-type toxicity. Careful history taking and reflecting diagnostic suspicion in the initial episode s record may reduce the incidence of this iatrogenic event.
Fernández-Castañer
A
A
Servicio de Aparato Digestivo, Hospital Universitario Virgen de La Victoria, Facultad de Medicina, Málaga.
García-Cortés
M
M
Lucena
M I
MI
Borraz
Y
Y
Peláez
G
G
Costa
J
J
Anzola
S
S
Salmerón
J
J
Avila
S
S
Durán
J A
JA
Malcón de Dios
A
A
Romero-Gómez
M
M
Madrazo
A
A
Muñoz-Yagüe
T
T
Andrade
R J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology* / Q000209:etiology*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies