title: Clinical Characteristics of Patients with Drug-induced Liver Injury.
abstract: BACKGROUND
  Drug is an important cause of liver injury and accounts for up to 40% of instances of fulminant hepatic failure. Drug-induced liver injury (DILI) is increasing while the diagnosis becomes more difficult. Though many drugs may cause DILI, 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 carers by analyzing the clinical and pathological characteristics of the DILI and the associated drug types.
  
  
  METHODS
  A retrospective analysis was conducted in 287 patients diagnosed with DILI 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 DILI, accounting for 163 out of the 287 DILI patients (56.79%) in our study. Among the Western medicine, antituberculosis drugs were the highest cause (18.47%, 53 patients) of DILI.   Antibiotics (18 patients, 6.27%) and antithyroid (18 patients, 6.27%) drugs also ranked among the major causes of DILI. Chinese herbal medicines are another major cause of DILI, 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 DILI, 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 DILI. For patients with liver injury of unknown origin, liver tissue pathological examination is recommended for further diagnosis.
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Yang
authors.affiliation: Department of Emergency, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Cheng-Yuan
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Lun-Li
authors.initials: LL
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Lai
authors.affiliation: Department of Emergency, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Fang
authors.affiliation: Department of Clinical Medicine, Medical College of Nanchang University, Nanchang, Jiangxi 330006, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D013956:Antithyroid Agents / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D002681:China; D004365:Drugs, Chinese Herbal / Q000009:adverse effects; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D013956:Antithyroid Agents; D000995:Antitubercular Agents; D004365:Drugs, Chinese Herbal