Drug induced liver injury natural history, complications and prognosis

Jump to navigation Jump to search

Drug induced liver injury Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Drug Induced Liver Injury from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Biopsy

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Drug Induced Liver Injury On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Drug induced liver injury

All Images
induced liver injury X-ray X-rays
induced liver injury Ultrasound Echo & Ultrasound
induced liver injury CT CT Images
induced liver injury MRI MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Drug induced liver injury

CDC on Drug induced liver injury

Drug induced liver injury in the news

Blogs on Drug induced liver injury

Directions to Hospitals Treating 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

The clinical course of drug induced liver injury varies based on causative drug.[1] There is a hallmark latent period between the initiation of the drug ("the challenge") and the development of either symptoms or, more commonly, asymptomatic elevations in serum alanine aminotransferase. Liver injury typically recurs if the drug is reintroduced in the future, often with greater severity that could be life-threatening. Prompt withdrawal of the offending drug leads to complete resolution in 90% of patients, with no long-term sequelae.

Natural History

There is a hallmark latent period between the initiation of the drug ("the challenge") and the development of either symptoms or, more commonly, asymptomatic elevations in serum alanine aminotransferase. Once the diagnosis of drug induced liver injury is established and the inciting drug is withdrawn, the "dechallenge" or clinical improvement is relatively immediate. Liver injury typically recurs if the drug is reintroduced in the future, often with greater severity that could be life-threatening.

Complications

The main complication that can develop as a result of drug induced liver injury is chronic liver failure in 5-10% of patients, particularly if they have preexisting liver disease. Up to 10% of patients with drug induced liver injury do not survive the initial injury or require liver transplantation. Overall, complications are dependent on the inciting drug and patient risk factors.

Prognosis

Prompt withdrawal of the offending drug leads to complete resolution in 90% of patients, with no long-term sequelae.

References

  1. Hayashi PH, Fontana RJ (2014). "Clinical features, diagnosis, and natural history of drug-induced liver injury". Semin Liver Dis. 34 (2): 134–44. doi:10.1055/s-0034-1375955. PMID 24879979.