The characteristics and clinical outcome of drug-induced liver injury: a single-center experience.
OBJECTIVE
The aim of this cohort study was to determine the characteristics and clinical outcome of 170 patients with drug-induced liver injury (DILI) in a single center.


METHODS
Between January 2001 and June 2007, a total of 170 individuals who were diagnosed with DILI were retrospectively analyzed. The median follow-up period was 110.0 days.


RESULTS
During the study period, a total of 5471 new patients were assessed for liver test abnormalities. Of those, 170 patients (3.1%) fulfilled the criteria of DILI. A total of 83 different drugs were considered to be related to the hepatotoxicity; a single drug was suspected in 57.6% of individuals. The median interval between the suspicious drug intake and DILI recognition was 15.0 days. Hepatocellular pattern was observed in 50.0% of patients with a mean alanine aminotransferase level of 952.2+/-907.0 U/L. The main causative group of drugs was antibiotics. Sixty-two patients required hospitalization; acute liver failure developed in 14 (8.2%), chronicity was observed in 19 (11.2%), and 7 died (4.1%). Overall, complete recovery occurred in 82% of patients. The presence of jaundice on admission and shorter interval period between drug intake and DILI recognition were identified as risk factors for the development of acute liver failure.


CONCLUSIONS
DILI is an important cause of liver test abnormalities in outpatient clinics, and antibiotics represent the most common drug group. Overall, complete recovery after the withdrawal of the suspicious drug occurred in the majority of patients, but DILI may progress to acute liver failure, chronicity, and death.
Idilman
Ramazan
R
Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey. idilman@dialup.ankara.edu.tr
Bektas
Mehmet
M
Cinar
Kubilay
K
Toruner
Murat
M
Cerit
Ethem Turgay
ET
Doganay
Beyza
B
Erden
Esra
E
Bozkaya
Hakan
H
Bahar
Kadir
K
Karayalcin
Selim
S
Soykan
Irfan
I
Palabiyikoglu
Murat
M
Cetinkaya
Hulya
H
Yurdaydin
Cihan
C
Dokmeci
Abdulkadir
A
Ozden
Ali
A
D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D017093:Liver Failure / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000970:Antineoplastic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors