A clinical-pathological analysis of drug induced hepatitis. Our experience of last 5 years.

Clinical characteristics of drug‐induced liver injury in the elderly

“…However, the greater the number of concomitant drugs, the more difficult it is to determine the causative agent for DILI. Recently, idiosyncratic injuries due to genetic polymorphisms of drug‐metabolizing enzymes, such as cytochrome P450 or UDP‐glucuronosyltransferase, have been reported to be increasing 4 . In this type of liver injury, when multiple drugs metabolized by the same enzyme are administered, drug metabolism may be prolonged and cytotoxic intermediate metabolites may induce hepatic injury.…”

“…Moreover, with the increasing number of new drugs and the frequent use of health foods, DILI is being caused by more drugs, including health foods 2,3 . Further, the clinical presentation of DILI has also changed due to an increasing number of cases without allergic symptoms 4 . Although it is essential to examine the characteristics of DILI in the elderly, there are few clinical studies that examine this disease by age, in Japan or elsewhere 5–7 …”

“…2,3 Further, the clinical presentation of DILI has also changed due to an increasing number of cases without allergic symptoms. 4 Although it is essential to examine the characteristics of DILI in the elderly, there are few clinical studies that examine this disease by age, in Japan or elsewhere. [5][6][7] Several factors associated with drug disposition change with age, 8 including distribution, metabolism, and elimination.…”

Drug-induced Liver Injury with Serious Multiform Exudative Erythema following the Use of an Over-the-counter Medication Containing Ibuprofen

“…The idiosyncratic type is further subclassified as involving an allergic (or hypersensitivity) reaction, presenting with extrahepatic manifestations, such as fever, rashes, eosinophilia and other forms of organ damage, or nonallergic (or metabolic) reaction, in which there are no extrahepatic manifestations (3,4). The frequency of the allergictype DILI has recently decreased (5). However, the liver is the most commonly involved internal organ in patients with drug-induced systemic hypersensitivity, and liver dysfunction is the major cause of death in those with certain phenotypes of drug hypersensitivity (6,7).…”