Presentations, Causes and Outcomes of Drug-Induced Liver Injury in Egypt.
Adult
Alanine Transaminase
/ blood
Alkaline Phosphatase
/ blood
Amoxicillin-Potassium Clavulanate Combination
/ adverse effects
Anti-Bacterial Agents
/ adverse effects
Chemical and Drug Induced Liver Injury
/ mortality
Cholestasis
/ chemically induced
Cyclooxygenase Inhibitors
/ adverse effects
Diclofenac
/ adverse effects
Egypt
Female
Hepatic Encephalopathy
/ chemically induced
Humans
Liver
/ drug effects
Liver Failure, Acute
/ chemically induced
Male
Middle Aged
Prognosis
Prospective Studies
Tertiary Care Centers
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
20 03 2020
20 03 2020
Historique:
received:
28
05
2019
accepted:
26
02
2020
entrez:
22
3
2020
pubmed:
22
3
2020
medline:
26
11
2020
Statut:
epublish
Résumé
Drug-induced liver injury (DILI) is a frequent cause of liver injury and acute liver failure. We aimed to review all hospitalized DILI cases in a tertiary Egyptian center from January 2015 through January 2016. Cases with elevated alanine aminotransferase more than 3-fold and/or alkaline phosphatase more than 2-fold the upper limit of normal value were prospectively recruited and followed for one year. Drug history, liver biopsy whenever feasible and application of Roussel Uclaf Causality Assessment Method (RUCAM) were the diagnostic prerequisites after exclusion of other etiologies of acute liver injury. In order of frequency, the incriminated drugs were: Diclofenac (31 cases, 41.3%), amoxicillin-clavulanate (14 cases, 18.7%), halothane toxicity (8 cases, 10.7%), ibuprofen (4 cases, 5.3%), Khat (3 cases, 4%), tramadol (3 cases, 4%), Sofosbuvir with ribavirin (2 cases, 2.7%), and acetylsalicylic acid (2 cases, 2.7%) with one offending drug in 93.3% of cases. Forty-four cases (58.7%) were males; while 56 cases (74.7%) had HCV related chronic liver disease. Thirty-two cases (42.7%) presented with pattern of hepatocellular injury, while 23 cases (30.7%) were with cholestasis, and 20 cases (20.7%) with a mixed hepatocellular/cholestatic injury. One case received a transplant (0.75%), 7 cases died (9.3%), 23 cases (30.6%) developed liver decompensation (hepatic encephalopathy and ascites), and 44 cases completely resolved (58.7%). In conclusion, Diclofenac is the commonest offender in DILI occurrence in an Egyptian cohort. Age and prothrombin concentration were the only predictors of unfavorable outcomes of DILI.
Identifiants
pubmed: 32198411
doi: 10.1038/s41598-020-61872-9
pii: 10.1038/s41598-020-61872-9
pmc: PMC7083870
doi:
Substances chimiques
Anti-Bacterial Agents
0
Cyclooxygenase Inhibitors
0
Diclofenac
144O8QL0L1
Amoxicillin-Potassium Clavulanate Combination
74469-00-4
Alanine Transaminase
EC 2.6.1.2
Alkaline Phosphatase
EC 3.1.3.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5124Références
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