Clinical analysis of 230 cases of drug-induced liver injury

Objective To review the clinical features of acute drug-induced liver injury. Methods The clinical data of 230 patients with acute drug-induced liver injury admitted to Beijing Ditan Hospital from October 2005 to May 2011 were retrospectively analyzed. Results In 230 patients, more than 60% had symptoms of fatigue, anorexia, jaundice and liver damage presenting LT, AST, ALP and TBIL changes. The hepatocellular injury type accounted for 80.4% (185/230), cholestatic type accounted 11.7% (27/230) and mixed type accounted for 7.8% (18/230). Chinese herbal medicine or Chinese patent medicine was the most common cause of drug-induced liver injury (55.2%), followed by anti-TB drugs (9.6%) and other anti-bacterial drugs (5.2%). There were 218 cases (94.7%) with favorable prognosis and 12 cases (5.3%) with poor prognosis, including 4 aggravating cases discharged against medical advance and 8 deaths. Conclusion The lack of gold standard for the diagnosis of drug-induced liver injury may easily lead to misdiagnosis. Chinese Traditional medicine, anti-TB drugs and other anti-microbial drugs are main causes of drug-induced liver injury. Early detection and timely treatment are important for the management of drug-induced liver injury. Key words: Retrospective studies; Drug-induced liver injury; Clinical features