Severe Jaundice in Sweden in the New Millennium: Causes, Investigations, Treatment and Prognosis

Abstract

Malignancy and alcoholic liver disease are the most common causes of severe jaundice, whereas viral hepatitis is a rare cause. Many patients are under surgical care, probably due to historical reasons as surgery is rarely indicated.

Epigallocatechin‐3‐gallate diminishes CCL2 expression in human osteoblastic cells via up‐regulation of phosphatidylinositol 3‐Kinase/Akt/Raf‐1 interaction: A potential therapeutic benefit for arthritis

“…For isoniazid median latency was 5 months; 6‐8 months in one‐third of the cases. As anticipated,10, 15, 19, 21 DILI in ALF was mostly hepatocellular (77.8%) compared to cholestatic and mixed reactions (19.2%) Conventional causes of cholestatic and mixed reactions (phenothiazines, macrolides, NSAIDs, carbamazepine, and phenytoin34, 52, 53) were rare. We confirmed that many drugs can cause cholestatic and mixed hepatotoxic reactions16, 19 (Table 3).…”

“…In a 1990s United Kingdom‐based survey,11 DILI requiring specialist referral affected 2.4 cases/100,000 person‐years (similar to the 1980s DILI incidence in Denmark12), of whom 36/128 (28.2%) were hospitalized, but only one required liver transplantation. DILI is a frequent cause of hepatitis13 and hospitalization,11, 12 and is implicated in 5%‐10% of all patients hospitalized for jaundice,14, 15 accounting for 95% of adverse drug reactions and 14.6% of drug fatalities in Denmark 12…”

Outcome and prognostic markers in severe drug‐induced liver disease†

“…Acute hepatic injury due to drugs has been reported to occur in 5% to 10% of patients hospitalized for jaundice. [1][2][3][4] Furthermore, drugs are the most common cause of fulminant hepatic failure, both in the United States and Europe. [5][6][7] In reports from the United States and Sweden, idiosyncratic drug reactions were the presumptive causes in 13% to 17% of cases of acute liver failure.…”

Análisis de las causas, características y consecuencias de la reexposición al fármaco o compuesto responsable de un episodio de hepatotoxicidad

“…Aunque no existen figuras consistentes de incidencia y prevalencia de los efectos adversos hepáticos, se estima que la causa tóxica supone entre el 4-10% de los casos de ictericia ingresados en un hospital general (3)(4)(5), pero la mayoría de los casos en un estudio reciente eran debidos a intoxicación con paracetamol, representando los casos debidos a hepatotoxicidad idiosincrásica únicamente un 0,7% (5). Un estudio prospectivo poblacional realizado en una región francesa estimó una tasa de incidencia anual de 14 casos por 100.000 habitantes de toxicidad hepática, con una incidencia estandarizada global de 80 casos por millón de habitantes y año (6).…”