Drug-induced Liver Disease: Etiology, Clinical Characteristics And Causality Assessment

Objective To analyze the incidence, etiology , clinical characteristics, prognosis and diagnostic accuracy of drug-induced liver disease(DILD). Methods Two hundred and twenty eight cases with drug-induced liver disease admitted to our hospital over a 6-year period were reviewed retrospectively. Drug history, clinical symptom and signs, laboratory tests and therapeutic effect were recorded. International consensus criteria were applied to assess the diagnosis of suspected drug hepatotoxicity.Results 1. There were 19 cases, 13 cases, 27 cases, 35 cases, 79 cases and 55 cases of DILD over a 6-year period, respectively. In the same period, there were 259 cases, 272 cases, 269 cases, 288 cases, 369 cases and 310 cases of acute hepatic injury. The incidence of hepatotoxicity was 7.3%, 4.8%, 10.0%, 12.2%, 21.4%, 17.7%, respectively .The incidence male/female ratio was 1. 35. The on-set peak age was between 30—49 year-old in 228 cases of DILD in this study.2. The offending agents could be classified as follow: anti-tuberculosis drug 33.8% (77/228), herbal medicine 24.6% (56/228) , anti-thyroid drugs 10.1 % (23/228) , antibiotics 5.3 % (12/228), cardiovascular drugs 3. 9% (9/228), anti-neoplastic agent, antipyretic analgesic and conservancy drugs 3.1 % ( 7/228 ) , antimycotic drug 2.6 % ( 6/228 ) , excitatory autacoid drugs, and hypoglycemic agent, 2.2 % ( 5/228 ) ,psychotropic drugs , immunosuppressive drugs, and antipodagrics 1. 3 % ( 3/228 ) , anti-epileptic drugs 0.9% (2/228), other drugs 1.3% (3/228) .