Mitochondrial and immunoallergic injury increase risk of positive drug rechallenge after drug-induced liver injury: A systematic review

Hunt, Christine M.

doi:10.1002/hep.24022

Cited by 34 publications

(26 citation statements)

References 58 publications

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“…Fatality resulting from hepatic dysfunction may occur after antiepileptic hypersensitivity syndrome both during the index episode 37 and, rarely, from prescription errors with crossreacting drugs. 38 Although rechallenge is routinely practiced with antituberculosis drugs, rechallenge in the setting of an episode of immunoallergic injury should not be attempted when alternative medications are available, 39,40 particularly for drugs that have a high rate of cross-reactivity, such as phenytoin, carbamazepine, and phenobarbitone. 41 Finally, the occurrence of DILI secondary to 6-MP and methotrexate is consistent with the observation of hepatotoxicity in children with acute lymphoblastic leukemia, as demonstrated in a recent study.…”

Section: Discussionmentioning

confidence: 99%

Drug-Induced liver injury with hypersensitivity features has a better outcome: A single-center experience of 39 children and adolescents

Devarbhavi

Karanth

et al. 2011

Hepatology

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Drug-induced liver injury (DILI) is rare in children and adolescents, and, consequently, data are remarkably limited. We analyzed the causes, clinical and biochemical features, natural history, and outcomes of children with DILI. Consecutive children with DILI from 1997 to 2004 (retrospective) and 2005 to 2010 (prospective) were studied based on standard criteria for DILI. Thirty-nine children constituted 8.7% of 450 cases of DILI. There were 22 boys and 17 girls. Median age was 16 years (range, 2.6-17). Combination antituberculous drugs were the most common cause (n 5 22), followed by the anticonvulsants, phenytoin (n 5 10) and carbamazepine (n 5 6). All of the 16 children (41%) who developed hypersensitivity features, such as skin rashes, fever, lymphadenopathy, and/or eosinophilia, including the 3 with Stevens-Johnson syndrome, survived. Those with hypersensitivity presented earlier (24.5 versus 35 days; P 5 0.24) had less severe disease (MELD, 16 versus 29; P 5 0.01) and had no mortality (0/16 versus 12/23; P < 0.001), compared to those without hypersensitivity. The 12 fatalities were largely the result of antituberculous DILI (n 5 11). The presence of encephalopathy and ascites were associated with mortality, along with hyperbilirubinemia, high international normalized ratio, and serum creatinine. According to the Roussel Uclaf Causality Assessment Method, 18 were highly probable, 14 probable, and 7 possible. Thirty-two children were hospitalized. Conclusion: DILI is not uncommon in children and accounts for 8.7% of all patients with DILI. Antituberculous drugs and anticonvulsants are the leading causes of DILI in India. Overall mortality is high (30.7%), largely accounted by antituberculous drugs. Children with DILI and hypersensitivity features present early, have less severe disease, and, consequently, a better prognosis, compared to those without, and are often associated with anticonvulsants or sulfonamides. (HEPATOLOGY 2011;54:1344-1350 T he last decade has seen an increasing number of reports on drug-induced liver injury (DILI) in adults across all regions of the world.

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Section: Discussionmentioning

confidence: 99%

Drug-Induced liver injury with hypersensitivity features has a better outcome: A single-center experience of 39 children and adolescents

Devarbhavi

Karanth

et al. 2011

Hepatology

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“…Although recurrence of hepatitis upon re-challenge is diagnostic of drug-induced liver injury (DILI), rechallenge is generally discouraged except when the drug is considered essential [14]. In this case, the patient developed hepatotoxicity 6 months after the initial trastuzumab dose.…”

Section: Discussionmentioning

confidence: 99%

Trastuzumab-Induced Hepatotoxicity: A Case Report

Vucicevic¹,

Carey²,

Karlin

2013

Breast Care

2,999

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Background: Trastuzumab is a humanized monoclonal antibody approved for the treatment of breast cancer with HER2 amplification and/or overexpression. There are only 2 prior cases of trastuzumab-related hepatotoxicity reported in the literature. Case Report: We report the case of a 60-year-old woman who was treated with trastuzumab for stage I invasive ductal carcinoma of the right breast. She successfully completed 6 months of therapy when an increase in liver transaminases was noted on routine examination. A full work-up for causes of acute and chronic liver disease was negative. After review of the patient's medication list, trastuzumab was thought to be the most likely culprit for the liver injury, based on timing of administration and rise in liver enzymes.

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“…Deliberate re-exposure (rechallenge) to the same drug suspected as causing acute iDILI is generally discouraged (73, 139, 229), for fear of producing an even more severe reaction, including death from ALF (230)(231)(232). For certain life-threatening illness, such as active tuberculosis, where no alternative therapies are available, desensitizationrechallenge strategies have been successfully implemented, whereby the same agents causing DILI can be restarted (233)(234)(235)(236).…”

Section: Densitization-rechallengementioning

confidence: 99%

The Art and Science of Diagnosing and Managing Drug-induced Liver Injury in 2015 and Beyond

Lewis

2015

Clinical Gastroenterology and Hepatology

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Mitochondrial and immunoallergic injury increase risk of positive drug rechallenge after drug-induced liver injury: A systematic review

Cited by 34 publications

References 58 publications

Drug-Induced liver injury with hypersensitivity features has a better outcome: A single-center experience of 39 children and adolescents

Drug-Induced liver injury with hypersensitivity features has a better outcome: A single-center experience of 39 children and adolescents

Trastuzumab-Induced Hepatotoxicity: A Case Report

The Art and Science of Diagnosing and Managing Drug-induced Liver Injury in 2015 and Beyond

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