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Hospital Admissions for Drug-Induced Liver Injury: Clinical Features, Therapy, and Outcomes

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Abstract

We investigated clinical features, therapy, and outcomes of patients hospitalized for drug-induced liver injury (DILI). DILI resolution was defined as liver biochemistry values back to normal or lower than CIOMS laboratory criteria; Chronicity was defined as persistent biochemical abnormality for >6 months after drugs’ withdrawal. Three-hundred cases were reviewed retrospectively; mean age 51 (13–86) years, and 204 (68 %) were females. It included 267 (89 %) hepatocellular injury, 16 (5.3 %) cholestatic injury, and 17 (5.7 %) mixed injury cases. In hepatocellular injury group, 197 (73.8 %) patients with TBIL < 10× ULN included 142 (72.1 %) females and 70 (26.2 %) patients with TBIL ≥ 10× ULN included 39 (55.7 %) females (P = 0.012). Of 70 patients (TBIL ≥ 10× ULN), 20 were treated with steroid step-down therapy (79 ± 26 days) and others with non-steroid therapy. The steroid therapy group showed higher DILI resolution rate (P = 0.029) and shorter recovery time (P = 0.012). Notably, 274/300 (91.3 %) patients resolved, 18/300 (6 %) developed chronic liver injury, 7/300 (2.3 %) died, and one patient received liver transplantation. In death group, TBIL, ALB, PT, and PTA revealed more severe abnormality than in recovery group. In 121/300 (40.3 %) patients, use of herbal medicines was the leading cause of liver injury, followed by antibiotics, cardiovascular drugs, and endocrine drugs. We concluded that step-down steroid therapy for DILI improved curative effect, shortened disease course, and was safe.

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Authors and Affiliations

  1. Department of Infectious Diseases and Center for Liver Diseases, Peking University First Hospital, No. 8, XiShiKu Street, XiCheng District, Beijing, 100034, China

    Feng-Qin Hou, Zheng Zeng & Gui-Qiang Wang

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  1. Feng-Qin Hou
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  2. Zheng Zeng
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  3. Gui-Qiang Wang
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Correspondence to Gui-Qiang Wang.

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Hou, FQ., Zeng, Z. & Wang, GQ. Hospital Admissions for Drug-Induced Liver Injury: Clinical Features, Therapy, and Outcomes. Cell Biochem Biophys 64, 77–83 (2012). https://doi.org/10.1007/s12013-012-9373-y

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