Drug induced liver injury history and symptoms
|
Drug induced liver injury Microchapters |
|
Differentiating Drug Induced Liver Injury from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Drug Induced Liver Injury On the Web |
|
American Roentgen Ray Society Images of Drug induced liver injury |
|
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 (Paracetamol_detailed_information#Toxic_dose), 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 treatment to the development of laboratory abnormalities and clinical manifestations. Specific clinical presentations of over 600 inciting drugs can also be found on the National Institute of Health LiverTox website [3], which is an open access resource for characteristic "signatures" associated with each drug.
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, malaise, 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 pruritis. Symptoms of severe drug induced liver injury include coagulopathy and altered mental status due to hepatic encephalopathy, which would be suggestive of acute liver failure.[2]
Specific symptoms may also vary based on the inciting drug and are categorized on the National Institute of Health LiverTox website [4].
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.