Drug induced liver injury history and symptoms
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Drug induced liver injury Microchapters |
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Differentiating Drug Induced Liver Injury from other Diseases |
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Diagnosis |
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Treatment |
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Drug Induced Liver Injury On the Web |
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Risk calculators and risk factors for Drug induced liver injury |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rachita Navara, M.D. [2]
Overview
Drug induced liver injury is largely a diagnosis of exclusion. Outside the drug nomogram for acetaminophen overdose, there are no definitive laboratory, biopsy, or imaging findings that are diagnostic of drug induced liver injury. However, it is increasingly recognized that certain drugs carry "signatures" that predict their potential for liver injury.[1] There are also characteristic features of the disease that span all inciting drug classes.
History
The hallmark of drug induced liver injury is a latent period from the onset of drug use to the development of laboratory abnormalities and clinical manifestations. Specific clinical presentations and characteristic "signatures" associated with over 600 inciting drugs can also be found here.
Symptoms
The majority of patients with drug induced liver injury are asymptomatic and the disease is only detected by laboratory abnormalities. Of those who are symptomatic of acute drug induced liver injury, the most common symptoms are fever, general ill feeling, nausea, vomiting, and if more advanced, jaundice, right upper quadrant pain, dark urine, and acholic stools. Patients who develop cholestatic liver injury may present with itching. Additional symptoms of severe drug induced liver injury include clotting defects and altered mental status due to hepatic encephalopathy, which would be suggestive of acute liver failure.[2]
References
- ↑ Watkins PB (2015). "How to Diagnose and Exclude Drug-Induced Liver Injury". Dig Dis. 33 (4): 472–6. doi:10.1159/000374091. PMID 26159261.
- ↑ Davern TJ (2012). "Drug-induced liver disease". Clin Liver Dis. 16 (2): 231–45. doi:10.1016/j.cld.2012.03.002. PMID 22541696.