Clinical analysis of 179 cases of acute drug-induced liver injury

Objective To investigate the clinical manifestation, designation, causative drugs, therapy and the prognosis of acute drug-induced liver injury to guide clinical diagnosis and therapy.Methods One hundred and seventy-nine inpatients with acute drug-induced liver injury in our hospital in the past five years(2000.1～2004.12) were retrospectively investigated with the causality assessment method of acute drug-induced liver diseases based on international consensus meeting (international criteria).Results No obvious symptoms and signs were shown in 48% cases. In this study, 137(76.11%), 24(14.33%),18(10.56%)cases were designated hepatocellular, cholestetic and mixed accordingly while 6 cases were diagnosed as severe liver injury. Many drugs could cause liver injury. The most common drugs were antineoplastic drugs,antituberculosis drugs and Chinese traditional and herbal drugs. Most of the cases (85.55%)recovered in 30 days after withdrawal of the causative drug(s) and giving proper supportive therapy though 6 cases developed into severe liver injury and had unfavorable prognosis.Conclusion The symptoms of acute drug-induced liver injury are unspecific, which the diagnosis should not base on. In this study, the most common designation is hepatocellular. Many drugs can cause acute liver injury. Liver function monitoring is necessary when using these kinds of drugs. The prognosis is usually good in this study. But severe liver injury can also occurs, so steps should be taken to handle this.