title: Drug-induced liver injury: A 2-year retrospective study of 1169 hospitalized patients in a single medical center.
abstract: BACKGROUND
  Although herbal medicines (HMs) are widely used in Asian and Western countries, medicinal information concerning their hepatic toxicity or interaction with conventional medicines (CMs) is sparse.
  
  
  OBJECTIVE
  The aim of our study was to estimate the prevalence of drug-induced liver injury (DILI) among total inpatients prescribed HMs or CMs. Furthermore, we noted all medications suspected to be associated with hepatotoxicity in the liver injury group during the period of hospitalization.
  
  
  METHODS
  We retrospectively observed medical records of 1169 inpatients in a single medical center from January 2012 to July 2014.
  
  
  METHODS
  Based on a database of the 1169 inpatients at a single medical center, we researched the occurrence rate and type of liver injury according to the criteria of the Council for International Organization of Medical Science (CIOMS). We also utilized a simplified Roussel Uclaf Causality Assessment Method (RUCAM) score for probable causality assessment between drugs and liver injury.
  
  
  RESULTS
  Among a total of 1169 inpatients, 13 cases whose baseline LFTs had been in the normal range at admission had abnormal liver parameters at the time of follow-up, and 11 of them (0.94%) were attributed to drugs: 0.43% (5 of 1169) to HMs, 0.43% (5 of 1169) to CMs, and 0.09% (1 of 1169) to combined drug classes. Two of them were found to have liver injury because of pneumonia and sepsis. As for liver injury type, 8 cases were hepatocellular, 2 were cholestatic, and 1 was of mixed pattern. The common causative HMs for hepatotoxicity were Ephedrae Herba and Scutellariae Radix, while CMs included antidepressants, antihistamines, and antibacterials.
  
  
  CONCLUSIONS
  We investigated approximate incidence rates and analyzed suspicious drugs associated with liver damage, which revealed a low frequency of liver injury induced by HMs. However, further study, based on a well-designed, long-term, multicenter prospective study, will be required to determine the safety of HMs.
authors.affiliation: College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Hong Jung
authors.initials: HJ
authors.lastname: Woo
authors.affiliation: Department of Internal Medicine, Kyung Hee University Korean Medicine Hospital, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
authors.forename: Ha Yeon
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyung Hee University Korean Medicine Hospital, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
authors.forename: Eun Sol
authors.initials: ES
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Kyung Hee University Korean Medicine Hospital, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea.
authors.forename: Young-Hwan
authors.initials: YH
authors.lastname: Cho
authors.affiliation: College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Youngchul
authors.initials: Y
authors.lastname: Kim
authors.affiliation: College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Jang-Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kyung Hee University Korean Medicine Hospital, 23, Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 130-872, Republic of Korea. Electronic address: obliviona@naver.com.
authors.forename: Eungyeong
authors.initials: E
authors.lastname: Jang
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology*; D029789:Ephedra / Q000009:adverse effects; D005260:Female; D006633:Histamine Antagonists / Q000009:adverse effects; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D028321:Plant Preparations / Q000009:adverse effects*; D056910:Republic of Korea; D012189:Retrospective Studies; D031363:Scutellaria / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D000928:Antidepressive Agents; D006633:Histamine Antagonists; D028321:Plant Preparations
keywords: Conventional medicines; Drug-induced liver injury; Herbal medicines; Liver function tests; Safety