Toggle Main Menu Toggle Search

Open Access padlockePrints

The natural history of histologically proved drug induced liver disease

Lookup NU author(s): Professor Chris Day

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

Background - The long term outcome of drug related liver disease is unknown. Aims - To study the natural history of histologically proved drug induced hepatotoxicity. Methods - 110 patients with liver biopsies coded either as drug induced liver disease or hepatitis/cholestasis of unknown aetiology were identified from hospital records 1978-1996. Review of case notes and histology identified 44 patients with definite drug induced hepatotoxicity. Forty surviving patients were invited to attend a follow up clinic. History, examination, full liver screens and isotope and ultrasound liver scans were repeated in all patients. Repeat liver biopsies were offered to patients with abnormal liver tests. Results - Presentation at index biopsy was jaundice in 24 patients, abnormal liver tests in 17, and hepatic failure in three. Antibiotics (n=13) and non-steroidal antiinflammatory drugs (n=11) were the most common drugs implicated. Initial histology showed acute hepatitis in six, chronic hepatitis in 20, and cholestasis in 18. At 1-19 years (median 5 years) follow up, 13/33 (39%) patients had persistent significant abnormalities in their liver blood tests and/or scans. Three of the five repeat liver biopsies performed showed significant abnormalities. Factors predicting persistence or development of chronic liver disease were fibrosis and continued exposure to the drug. Conclusions - Drugs should be considered in the differential diagnosis of abnormal liver function and/or histology, as failure to withdraw the offending drug is associated with a high risk of persistent liver damage.


Publication metadata

Author(s): Aithal PG, Day CP

Publication type: Article

Publication status: Published

Journal: Gut

Year: 1999

Volume: 44

Issue: 5

Pages: 731-735

Print publication date: 01/01/1999

ISSN (print): 0017-5749

ISSN (electronic): 1468-3288

Publisher: BMJ Group

URL: http://dx.doi.org/10.1136/gut.44.5.731

DOI: 10.1136/gut.44.5.731

PubMed id: 10205214


Altmetrics

Altmetrics provided by Altmetric


Share