Causative agents and clinical features of 107 patients with drug-induced liver disease

Objective To describe the clinical features of drug-induced liver disease, in order to improve the diagnosis and treatment of drug-induced liver disease. Methods One hundred and seven cases of drug-induced liver disease admitted to our hospital from 1992 to 2004 were reviewed retrospectively. Results The offending agents could be classified as follows: antimicrobial agents(28%), immunosuppressive agents (18.4%), herbal medicine (13.8%), nonsteroidal anti-inflammatory drugs (10.3%), cardiovascular drugs (9.2%), sex steroids (8%), endocrinal drugs (4.6%) and mescillaneous (8.0%). 58.6%(62/107) were classified as hepatocellular type, 26.5% (28/107) as cholestatic type, and 14.9%(17/107)as mixed type. 93% patients recovered within 6 months, only one patient died.Conclusions A thorough history of medication should be taken in all patients presenting with abnormal liver function tests. Antimicrobial drugs, immunosuppressive drugs and herbal medicine were the most frequent hepatoxic factors in this sesies. In the majority of cases, the liver injury was resolved after prompt withdrawal of the relevant drugs, but in some cases, the liver injury was severe, and may progress to liver cirrhosis.