Drug‐Induced Liver Disease

Chitturi, Shivakumar; Farrell, Fracp Geoffrey C.

doi:10.1002/9781119950509.ch27

Cited by 20 publications

(24 citation statements)

References 606 publications

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“…Anti-tuberculosis drug induced liver injury (ATLI) is one of the most important and serious adverse effects [7], [8], which accounts for more than 7.0% of the overall adverse effects [9], [10]. The incidence of ATLI during standard multi-drug TB treatment has been reported varying from 2.0% to 28.0% according to different populations and definitions [7].…”

Section: Introductionmentioning

confidence: 99%

Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China

et al. 2011

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BackgroundAnti-tuberculosis drug induced liver injury (ATLI) is emerging as a significant threat to tuberculosis control in China, though limited data is available about the burden of ATLI at population level. This study aimed to estimate the incidence of ATLI, to better understand its clinical features, and to evaluate its impact on anti-tuberculosis (TB) treatment in China.Methodology/Principal FindingsIn a population-based prospective study, we monitored 4,304 TB patients receiving directly observed treatment strategy (DOTS) treatment, and found that 106 patients developed ATLI with a cumulative incidence of 2.55% (95% Confidence Interval [CI], 2.04%–3.06%). Nausea, vomiting and anorexia were the top three most frequently observed symptoms. There were 35 (33.02%) ATLI patients with no symptoms, including 8 with severe hepatotoxicity. Regarding the prognosis of ATLI, 84 cases (79.25%) recovered, 18 (16.98%) improved, 2 (1.89%) failed to respond to the treatment with continued elevation of serum alanine aminotransferase, and 2 (1.89%) died as result of ATLI. Of all the ATLI cases, 74 (69.81%) cases changed their anti-TB treatment, including 4 (3.77%) cases with medication administration change, 21 (19.81%) cases with drugs replacement, 54 (50.94%) cases with therapy interruption, and 12 (11.32%) cases who discontinued therapy. In terms of treatment outcomes, 53 (51.46%) cases had TB cured in time, 48 (46.60%) cases had therapy prolonged, and 2 (1.94%) cases died. Compared with non-ATLI patients, ATLI patients had a 9.25-fold (95%CI, 5.69–15.05) risk of unsuccessful anti-TB treatment outcomes and a 2.11-fold (95%CI,1.23–3.60) risk of prolonged intensive treatment phase.Conclusions/SignificanceATLI could considerably impact the outcomes of anti-TB treatment. Given the incidence of ATLI and the size of TB population in China, the negative impact is substantial. Therefore, more research and efforts are warranted in order to enhance the diagnosis and the prevention of ATLI.

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Section: Introductionmentioning

confidence: 99%

Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China

et al. 2011

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“…The initial hepatotoxic event could have been the result of hepatic adaptation (ie, transaminase elevation that reflects mild, nonprogressive injury to hepatocyte cell membranes and organelles) [2,3]; could have been unrelated to any of the TB medications; or could have been the result of 1 or more of the TB medications causing true, potentially progressive TB-DILI. In the first 2 instances, it is likely that all TB medications would be tolerated with rechallenge.…”

mentioning

confidence: 99%

Challenges in Reintroducing Tuberculosis Medications after Hepatotoxicity

Saukkonen

2010

CLIN INFECT DIS

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“…In humans, several drugs, such as flucloxacillin, chlorpromazine, and carbamazepine, and hepatotoxic agents have been reported to cause bile-duct loss [8]. Some of these compounds induce bile-duct injury at a specific anatomical level of the intrahepatic biliary tree [4].…”

Section: Discussionmentioning

confidence: 99%

Destructive Cholangitis in an Adult Jack Russell Terrier

Kodama

Sakai

Kimura

et al. 2012

Case Reports in Veterinary Medicine

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A 4-year-old female Jack Russell terrier dog exhibited vomiting and severe jaundice of the visible mucous membranes and skin. Ultrasonography revealed diffuse areas of high echogenicity and focal areas of low echogenicity in the left lobe of the liver. On macroscopic observation of the biopsied liver specimen, many scattered irregularly shaped red spots were observed on the liver surface and on the cut surface. Histopathologically, there was loss of the interlobular bile duct and cholangitis accompanied by infiltration of pigment-laden macrophages in the Glisson's capsule. Therefore, in the present case the dog was diagnosed with destructive cholangitis.

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Drug‐Induced Liver Disease

Cited by 20 publications

References 606 publications

Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China

Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China

Challenges in Reintroducing Tuberculosis Medications after Hepatotoxicity

Destructive Cholangitis in an Adult Jack Russell Terrier

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