Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States
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Chalasani, Naga, et al. Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-induced Liver Injury In the United States. 2008. https://doi.org/10.17615/fdkc-zt56APA
Chalasani, N., Fontana, R., Bonkovsky, H., Watkins, P., Davern, T., Serrano, J., Yang, H., Rochon, J., & Induced Liver Injury Network (Dilin), D. (2008). Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United States. https://doi.org/10.17615/fdkc-zt56Chicago
Chalasani, Naga, Robert J Fontana, Herbert L Bonkovsky, Paul Watkins, Timothy Davern, Jose Serrano, Hongqiu Yang et al. 2008. Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury In the United States. https://doi.org/10.17615/fdkc-zt56- Creator
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Chalasani, Naga
- Other Affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana; Clarian/Indiana University Digestive Diseases Center, Indianapolis, Indiana
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Fontana, Robert J.
- Other Affiliation: Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
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Bonkovsky, Herbert L.
- Affiliation: School of Medicine, Department of Medicine, Division of General Medicine and Clinical Epidemiology
- Other Affiliation: Cannon Research Center and Center for Liver and Digestive Diseases, Carolinas Medical Center, Charlotte, North Carolina; Department of Internal Medicine, University of Connecticut, Farmington, Connecticut
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Watkins, Paul
- Affiliation: School of Medicine, Department of Medicine, Division of General Medicine and Clinical Epidemiology
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Davern, Timothy
- Other Affiliation: Department of Internal Medicine, University of California, San Francisco, San Francisco, California
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Serrano, Jose
- Other Affiliation: Liver Disease Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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Yang, Hongqiu
- Other Affiliation: Duke Clinical Research Institute, Durham, North Carolina
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Rochon, James
- Other Affiliation: Duke Clinical Research Institute, Durham, North Carolina
- Drug Induced Liver Injury Network (DILIN)
- Abstract
- Background and Aims Idiosyncratic drug-induced liver injury (DILI) is among the most common causes of acute liver failure in the United States, accounting for approximately 13% of cases. A prospective study was begun in 2003 to recruit patients with suspected DILI and create a repository of biological samples for analysis. This report summarizes the causes, clinical features, and outcomes from the first 300 patients enrolled. Methods Patients with suspected DILI were enrolled based on predefined criteria and followed up for at least 6 months. Patients with acetaminophen liver injury were excluded. Results DILI was caused by a single prescription medication in 73% of the cases, by dietary supplements in 9%, and by multiple agents in 18%. More than 100 different agents were associated with DILI; antimicrobials (45.5%) and central nervous system agents (15%) were the most common. Causality was considered to be definite in 32%, highly likely in 41%, probable in 14%, possible in 10%, and unlikely in 3%. Acute hepatitis C virus (HCV) infection was the final diagnosis in 4 of 9 unlikely cases. Six months after enrollment, 14% of patients had persistent laboratory abnormalities and 8% had died; the cause of death was liver related in 44%. Conclusions DILI is caused by a wide array of medications, herbal supplements, and dietary supplements. Antibiotics are the single largest class of agents that cause DILI. Acute HCV infection should be excluded in patients with suspected DILI by HCV RNA testing. The overall 6-month mortality was 8%, but the majority of deaths were not liver related.
- Date of publication
- 2008
- DOI
- Identifier
- https://doi.org/10.1053/j.gastro.2008.09.011
- 2-s2.0-57249086242
- Related resource URL
- Resource type
- Article
- Rights statement
- In Copyright
- Journal title
- Gastroenterology
- Journal volume
- 135
- Journal issue
- 6
- Page start
- 1924
- Page end
- 1934
- Language
- English
- Version
- Postprint
- ISSN
- 0016-5085
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