Clinical Characteristics of 162 Patients with Drug-Induced Liver and/or Kidney Injury

Wang, Xiaolin; Chen, Xiangmei

doi:10.1155/2020/3930921

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…Anti‐tuberculosis drug‐induced hepatotoxicity (ATDH) is the most serious adverse drug reaction during the course of tuberculosis (TB) therapy 1 . ATDH is defined as the inflammation of hepatocytes caused by idiosyncratic reaction to the anti‐TB drugs 2 . The following 4 mechanisms are considered as the pathogenesis of ATDH: I) the enzymes and pathways about drug metabolizing, such as glutathione S‐transferase (GST) and N ‐acetyl transferase 2 (NAT2); II) the accumulation of bile acids, lipids, and heme metabolites; III) the toxicity mediated by immune system; IV) the increasing oxidant stress 3‐6 .…”

Section: Introductionmentioning

confidence: 99%

Collagen type XVIII alpha 1 chain (COL18A1) variants affect the risk of anti‐tuberculosis drug‐induced hepatotoxicity: A prospective study

Jiao

Wang

et al. 2020

Clinical Laboratory Analysis

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Background The role of collagen type XVIII alpha 1 chain (COL18A1) in anti‐tuberculosis drug‐induced hepatotoxicity (ATDH) has not been reported. This study aimed to explore the association between of COL18A1 variants and ATDH susceptibility. Methods A total of 746 patients were enrolled in our study from December 2016 to April 2018, and all subjects in the study signed an informed consent form. The custom‐by‐design 2x48‐Plex SNPscanTM kit was used to genotype all selected 11 SNPs. Categorical variables were compared by chi‐square (χ2) or Fisher's exact test, while continuous variables were compared by Mann‐Whitney's U test. Plink was utilized to analyze allelic and genotypic frequencies, and genetic models. Multivariate logistic regression analyses were used to adjust potential factors. The odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were also calculated. Results Among patients with successfully genotyping, there were 114 cases and 612 controls. The mutant A allele of rs12483377 conferred the decreased risk of ATDH (OR = 0.13, 95%CI: 0.02–0.98, P = 0.020), and this significance still existed after adjusting age and gender (P = 0.024). The mutant homozygote AA genotype of rs12483377 was associated with decreased total protein levels (P = 0.018). Conclusion Our study first revealed that the A allele of COL18A1 rs12483377 was associated with the decreased risk of ATDH in the Western Chinese Han population, providing new perspective for the molecular prediction, precise diagnosis, and individual treatment of ATDH.

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Section: Introductionmentioning

confidence: 99%

Collagen type XVIII alpha 1 chain (COL18A1) variants affect the risk of anti‐tuberculosis drug‐induced hepatotoxicity: A prospective study

Jiao

Wang

et al. 2020

Clinical Laboratory Analysis

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“…2,3 Anti-TB drugs are the second leading cause of druginduced liver injury (DILI) in China, after traditional Chinese herbal medicine, 4,5 with anti-TB DILI accounting for 15.3%-31.3% of all cases of DILI. [4][5][6] There have been few population-based studies of anti-TB DILI in China; however, studies in a TB-endemic region in India found that anti-TB DILI patients who developed acute liver failure (ALF) accounted for approximately 5%-25.7% of all ALF cases. [7][8][9] In contrast, approximately 39% of all ALF cases in the United States resulted from paracetamolinduced liver injury.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for acute liver failure among inpatients with anti-tuberculosis drug-induced liver injury

et al. 2018

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Objective: To analyze the clinical and laboratory features and determine the predictors of acute liver failure (ALF) among inpatients with anti-tuberculosis (TB) drug-induced liver injury (DILI). Method: Patients diagnosed with anti-TB DILI from 2010 to 2016 at The First Affiliated Hospital of Zhejiang University were retrospectively included in this study. Demographic and clinical data were collected by reviewing electronic medical records. Results: Among 155 inpatients with anti-TB DILI, 55 (35.48%) developed ALF, with an overall mortality of 9.68%. The median time to DILI onset was significantly longer in the ALF compared with the non-ALF group (51 versus 24 days). Eighty-three patients (53.55%) developed DILI (53.55%) within the first month of anti-TB treatment, and 60% of ALF cases occurred within 2 months. Multivariable models for ALF incorporating aspartate aminotransferase, total bilirubin, platelets, white blood cell count, and pre-existing hepatitis yielded a concordance (C-statistic) of 98.93%. Conclusions: The results of this study suggest that approximately half of all cases of DILI occur within the first month, while 60% of ALF cases occur within 2 months. Elevated total bilirubin, aspartate aminotransferase, white blood cell count, pre-existing hepatitis, and low platelet count are independent risk factors for the development of anti-TB drug-induced ALF.

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“…3,8 In countries with a high TB burden, such as India and China, AT-DILI accounts for a large proportion of all DILI cases. 6,7,[9][10][11][12][13][14] In addition, the occurrence of DILI significantly affects drug selection and course of treatment. For AT-DILI management, the guidelines published by the American Thoracic Society (2006; updated 2016), 2,15 Asia Pacific Association of Study of Liver (APASL; 2021), 3 the National Institute for Health and Clinical Excellence (NICE) of the UK, 4 British Thoracic Society (BST), 16 and the World Health Organization (WHO; 2010), 5 recommend that liver function tests (LFTs) need not be performed routinely if the baseline was normal and unless symptoms, such as human immunodeficiency virus (HIV) infection, primary liver diseases, or current pregnancy, arise in patients who are not at high risk.…”

Section: Introductionmentioning

confidence: 99%

Time of Liver Function Abnormal Identification on Prediction of the Risk of Anti-tuberculosis-induced Liver Injury

Huang¹,

Peng²,

Liu³

et al. 2022

J Clin Transl Hepatol

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Background and Aims: Anti-tuberculosis (anti-TB) druginduced liver injury (AT-DILI) is the most common side effect in patients who received anti-TB therapy. AT-DILI management includes monitoring liver function until symptoms arise in patients without high-risk factors for liver damage. The present study aimed to investigate the effect of liver function test (LFT) abnormal identification on the risk of DILI, including liver failure and anti-TB drug resistance in patients without high-risk factors. Methods: A total of 399 patients without high-risk factors for liver damage at baseline and who experienced LFT abnormal during the 6 months of first-line anti-TB treatment were enrolled. The Roussel Uclaf Causal Relationship Assessment Method (RU-CAM, 2016) was applied in suspected DILI. The correlations between the time of LFT abnormal identification and DILI, liver failure, and anti-TB drug resistance were analyzed by smooth curve fitting and multivariable logistic regression models. Results: Among all study patients, 131 met the criteria for DILI with a mean RUCAM causality score of 8.86±0.63. 26/131 and 105/131 were in the probable grading and highly probable grading, respectively. The time of abnormal LFT identification was an independent predictor of DILI, liver failure, and anti-TB drug resistance in the crude model and after adjusting for other risk patient factors. The time of abnormal LFT identification was positively correlated with DILI, liver failure, and anti-TB drug resistance. The late identification group (>8 weeks) had the highest risk of DILI, followed by liver failure compared with the other two groups. Conclusions: The time to identification of LFT was positively correlated with DILI, liver failure, and anti-TB drug resistance. The risk of DILI and liver failure was significantly increased in the late identification group with abnormal LFT identified after 8 weeks compared with 4 and 8 weeks. Early monitoring of LFT is recommended for patients without the high-risk factor of DILI after anti-TB treatment is initiated.

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Clinical Characteristics of 162 Patients with Drug-Induced Liver and/or Kidney Injury

Cited by 7 publications

References 26 publications

Collagen type XVIII alpha 1 chain (COL18A1) variants affect the risk of anti‐tuberculosis drug‐induced hepatotoxicity: A prospective study

Collagen type XVIII alpha 1 chain (COL18A1) variants affect the risk of anti‐tuberculosis drug‐induced hepatotoxicity: A prospective study

Risk factors for acute liver failure among inpatients with anti-tuberculosis drug-induced liver injury

Time of Liver Function Abnormal Identification on Prediction of the Risk of Anti-tuberculosis-induced Liver Injury

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