Vanishing bile duct syndrome after drug-induced liver injury.

Humans Female Child Adult Male Cholestasis / chemically induced Chemical and Drug Induced Liver Injury / etiology Bilirubin Bile Ducts Anti-Bacterial Agents / adverse effects
Beta-lactams Cholestasis Drug therapy Prognosis

Journal

Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659

Informations de publication

Date de publication:
11 2022
Historique:
received: 23 03 2022
revised: 23 08 2022
accepted: 02 09 2022
pubmed: 7 9 2022
medline: 10 11 2022
entrez: 6 9 2022
Statut: ppublish

Résumé

Vanishing bile duct syndrome (VBDS) is a serious cholestatic liver disease that can be a complication of drug-induced liver injury (DILI). While journals have published case reports of this condition, large studies on a cohort of these patients are lacking. We aimed to compile published case reports and case series of patients with VBDS and DILI to describe the clinical and laboratory characteristics of the disease and identify factors associated with good and poor outcomes. We included case reports and case series of VBDS secondary only to DILI. We extracted demographic, clinical, laboratory, treatment, and exposure data from each case report and categorized cases by outcome, good versus poor. We defined poor outcomes as cases with severe long-term complications or death. We analyzed risk factors for poor outcomes using logistic regression. We identified a total of 59 eligible cases. Of those, 39 (59%) were female, the median age was 36 (IQR:12-58), and 18 (31%) were pediatric cases (≤18 years). The most common offending drug class was antibiotics, especially beta-lactams. Patients with increased total bilirubin (OR=4.69; 95% CI=1.55-15.49; p = 0.008), increased direct bilirubin (OR=6.50; 95% CI=1.34-48.91; p = 0.034), lower liver synthetic activity (OR=0.11; 95% CI=0.02-0.55; p = 0.013), and older age (OR=3.31; 95% CI=1.15-10.04; p = 0.029) were more likely to develop poor outcomes. In patients with VBDS and DILI, antibiotics were the most common offending agents. Higher total and direct bilirubin levels were associated with poor outcomes.

Sections du résumé

BACKGROUND
Vanishing bile duct syndrome (VBDS) is a serious cholestatic liver disease that can be a complication of drug-induced liver injury (DILI). While journals have published case reports of this condition, large studies on a cohort of these patients are lacking. We aimed to compile published case reports and case series of patients with VBDS and DILI to describe the clinical and laboratory characteristics of the disease and identify factors associated with good and poor outcomes.
METHODS
We included case reports and case series of VBDS secondary only to DILI. We extracted demographic, clinical, laboratory, treatment, and exposure data from each case report and categorized cases by outcome, good versus poor. We defined poor outcomes as cases with severe long-term complications or death. We analyzed risk factors for poor outcomes using logistic regression.
RESULTS
We identified a total of 59 eligible cases. Of those, 39 (59%) were female, the median age was 36 (IQR:12-58), and 18 (31%) were pediatric cases (≤18 years). The most common offending drug class was antibiotics, especially beta-lactams. Patients with increased total bilirubin (OR=4.69; 95% CI=1.55-15.49; p = 0.008), increased direct bilirubin (OR=6.50; 95% CI=1.34-48.91; p = 0.034), lower liver synthetic activity (OR=0.11; 95% CI=0.02-0.55; p = 0.013), and older age (OR=3.31; 95% CI=1.15-10.04; p = 0.029) were more likely to develop poor outcomes.
CONCLUSIONS
In patients with VBDS and DILI, antibiotics were the most common offending agents. Higher total and direct bilirubin levels were associated with poor outcomes.

Identifiants

DOI: 10.1016/j.clinre.2022.102015 PMID: 36067952
pubmed: 36067952
pii: S2210-7401(22)00149-8
doi: 10.1016/j.clinre.2022.102015
pii:
doi:

Substances chimiques

Bilirubin RFM9X3LJ49
Anti-Bacterial Agents 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102015

Informations de copyright

Copyright © 2022 Elsevier Masson SAS. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests The authors declare no financial or personal conflicts of interest.

Auteurs

Paul Wasuwanich (P)

University of Florida College of Medicine, Gainesville, FL, USA.

Hassan Choudry (H)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Joshua M So (JM)

University of Florida College of Medicine, Gainesville, FL, USA.

Sarah Lowry (S)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Wikrom Karnsakul (W)

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: wkarnsa1@jhmi.edu.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Vanishing bile duct syndrome after...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Vanishing bile duct syndrome after...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Vanishing bile duct syndrome after...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladie des voies biliaires › Maladies des canaux biliaires › Cholestase › Vanishing bile duct syndrome after...
questionsmedicales.fr › Troubles dus à des produits chimiques › Intoxication › Lésions hépatiques dues aux substances › Vanishing bile duct syndrome after...
questionsmedicales.fr › Facteurs biologiques › Pigments biologiques › Pigments biliaires › Bilirubine › Vanishing bile duct syndrome after...
questionsmedicales.fr › Système digestif › Voies biliaires › Conduits biliaires › Vanishing bile duct syndrome after...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Vanishing bile duct syndrome after...