BACKGROUND AND AIM: The epidemiology of acute drug-induced liver injury (DILI) in the United States has not been well studied. We conducted a study of adults with new-onset jaundice at a nonreferral community hospital to better understand the epidemiology of acute DILI. METHODS: This is a retrospective study of adult outpatients and inpatients (> or =18 yr) with new-onset jaundice over a 5-yr period (1999-2003) at Wishard Memorial Hospital, Indiana. Patients with new-onset jaundice were identified using our electronic medical record system and individual medical records were reviewed to extract the required clinical data. New-onset jaundice was defined as the presence of total serum bilirubin >3 mg/dL in patients without a prior total bilirubin >3 mg/dL. RESULTS: A total of 732 eligible adults constituted our study cohort. Sepsis or altered hemodynamic state resulting in presumed ischemic liver injury is the single most common cause of jaundice (22%). Acute liver disease as a result of nonalcoholic etiologies caused new-onset jaundice in 97 patients (13%), with acute viral hepatitis in 66 patients (9%) and DILI in 29 patients (4%). Most cases of DILI were as a result of acetaminophen toxicity with idiosyncratic DILI occurring in only five patients (0.7%). No mortality was observed at 6 wk in patients who developed idiosyncratic DILI. CONCLUSION: Idiosyncratic DILI appears to be a rare cause of new-onset jaundice in a community hospital setting.
BACKGROUND AND AIM: The epidemiology of acute drug-induced liver injury (DILI) in the United States has not been well studied. We conducted a study of adults with new-onset jaundice at a nonreferral community hospital to better understand the epidemiology of acute DILI. METHODS: This is a retrospective study of adult outpatients and inpatients (> or =18 yr) with new-onset jaundice over a 5-yr period (1999-2003) at Wishard Memorial Hospital, Indiana. Patients with new-onset jaundice were identified using our electronic medical record system and individual medical records were reviewed to extract the required clinical data. New-onset jaundice was defined as the presence of total serum bilirubin >3 mg/dL in patients without a prior total bilirubin >3 mg/dL. RESULTS: A total of 732 eligible adults constituted our study cohort. Sepsis or altered hemodynamic state resulting in presumed ischemic liver injury is the single most common cause of jaundice (22%). Acute liver disease as a result of nonalcoholic etiologies caused new-onset jaundice in 97 patients (13%), with acute viral hepatitis in 66 patients (9%) and DILI in 29 patients (4%). Most cases of DILI were as a result of acetaminophentoxicity with idiosyncratic DILI occurring in only five patients (0.7%). No mortality was observed at 6 wk in patients who developed idiosyncratic DILI. CONCLUSION: Idiosyncratic DILI appears to be a rare cause of new-onset jaundice in a community hospital setting.
Authors: Robert J Fontana; Paul H Hayashi; Jiezhun Gu; K Rajender Reddy; Huiman Barnhart; Paul B Watkins; Jose Serrano; William M Lee; Naga Chalasani; Andrew Stolz; Timothy Davern; Jayant A Talwakar Journal: Gastroenterology Date: 2014-03-27 Impact factor: 22.682
Authors: Robert J Fontana; Leonard B Seeff; Raúl J Andrade; Einar Björnsson; Christopher P Day; Jose Serrano; Jay H Hoofnagle Journal: Hepatology Date: 2010-08 Impact factor: 17.425
Authors: J Jiang; X Zhang; R Huo; X Li; Y Yang; Z Gai; M Xu; L Shen; L Cai; C Wan; B Li; L He; S Qin Journal: Pharmacogenomics J Date: 2014-12-02 Impact factor: 3.550
Authors: Maricruz Vega; Manisha Verma; David Beswick; Stephanie Bey; Jared Hossack; Nathan Merriman; Ashish Shah; Victor Navarro Journal: Drug Saf Date: 2017-09 Impact factor: 5.606