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Titolo:
The natural history of histologically proved drug induced liver disease
Autore:
Aithal, PG; Day, CP;
Indirizzi:
Sch Med, Liver Res Ctr, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England Sch Med Newcastle Upon Tyne Tyne & Wear England NE2 4HH e & Wear, England
Titolo Testata:
GUT
fascicolo: 5, volume: 44, anno: 1999,
pagine: 731 - 735
SICI:
0017-5749(199905)44:5<731:TNHOHP>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADVERSE-REACTIONS; HEPATIC-NECROSIS; HEPATOTOXICITY; DENMARK; INJURY; DAMAGE;
Keywords:
drugs; chronic active hepatitis; toxic hepatitis; diclofenac;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Day, CP Sch Med, Liver Res Ctr, Framlington Pl, Newcastle Upon Tyne NE2 4HH, Tyne & Sch Med Framlington Pl Newcastle Upon Tyne Tyne & Wear England NE2 4HH
Citazione:
P.G. Aithal e C.P. Day, "The natural history of histologically proved drug induced liver disease", GUT, 44(5), 1999, pp. 731-735

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 identified44 patients with definite drug induced hepatotoxicity. Forty surviving patients were invited to attend a follow up clinic. History, examination, fullliver screen, 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, abnormalliver 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 in20, 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.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/02/20 alle ore 11:39:06