Clinical Analysis of 185 Cases of Drug-induced Liver Disease

Objective In order to enhance the understanding and improve the treatment and early diagnosis of acute drug-induced liver disease,we analyzed the etiology,clinical features,diagnosis and prognosis of drug-induced liver disease in recent years.Methods From January 2007 to December 2010,185 cases confirmed acute drug-induced liver disease in our hospital according to Maria's Clinical Diagnostic Scale(CDS) were retrospectively reviewed.The clinical features of drug-induced liver disease were analyzed.Results With Maria's diagnostic scale in 185 patients,63 cases scored 10 to 13 points(possibly drug-induced liver disease),122 cases scored 14 to 17 points(probably drug-induced liver disease).Among them,151 cases were hepatocellular type(81.6%),27 cases were cholestatic type(14.6%) and 7 cases were mixed type(3.9%).Suspicious drugs to cause liver disease by percentage descending order were Chinese herbal medicine(25.9%),antituberculosis drugs(16.8%),antineoplastic agents(11.4%),antibiotics drugs(6.5%),anti-thyroid drugs(5.4%),lipid-lowering drugs and cardiovascular disease drugs(4.9%).The principal clinical manifestation included fatigue(70.3%),anorexia(61.1%),tired of greasy(54.6%),colored urine(53.0%),and 21.1% patients had no symptoms.Most patients were cured with good prognosis.The total effect was 95.8% after treatment.Conclusion Chinese herbal medicine,anti-TB drugs,anticancer drugs and antibiotics are the major cause of drug-induced liver injury,the vast majority occurred in the 12 weeks.The main clinical type of drug-induced liver injury is hepatocellular type;its clinical features are non-specific,similar with varieties of acute/chronic liver and gallbladder diseases.Early detection,timely disabling liver damage drugs is a prerequisite for treatment.The vast majority of drug-induced liver disease prognosis is good.