Background-The long term outcome of drug related liver disease is unknown.
Aims-To study the natural history of histologically proved drug induced hepatotoxicity.
Methods-110 patients with liver biopsies coded either as drug induced liver disease or hepatitis/cholestasis of unknown aetiology were identified from hospital records 1978-1996.
Review of case notes and histology identified 44 patients with definite drug induced hepatotoxicity.
Forty surviving patients were invited to attend a follow up clinic.
History, examination, full liver screen, and isotope and ultrasound liver scans were repeated in all patients.
Repeat liver biopsies were offered to patients with abnormal liver tests.
Presentation at index biopsy was jaundice in 24 patients, abnormal liver tests in 17, and hepatic failure in three.
Antibiotics (n=13) and non-steroidal antiinflammatory drugs (n=11) were the most common drugs implicated.
Initial histology showed acute hepatitis in six, chronic hepatitis in 20, and cholestasis in 18.
At 1-19 years (median 5 years) follow up, 13133 (39%) patients had persistent significant abnormalities in their liver blood tests and/or scans.
Three of the five repeat liver biopsies performed showed significant abnormalities.
Factors predicting persistence or development of chronic liver disease were fibrosis and continued exposure to the drug. (...)
Mots-clés Pascal : Hépatite, Toxique, Dépistage, Chimiothérapie, Effet secondaire, Etiologie, Histologie, Biopsie, Article synthèse, Royaume Uni, Europe, Homme, Etude longitudinale, Appareil digestif pathologie, Foie pathologie, Toxicologie, Pharmacovigilance, Prévention
Mots-clés Pascal anglais : Hepatitis, Poison, Medical screening, Chemotherapy, Secondary effect, Etiology, Histology, Biopsy, Review, United Kingdom, Europe, Human, Follow up study, Digestive diseases, Hepatic disease, Toxicology, Pharmacovigilance, Prevention
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0247876
Code Inist : 002B02U04. Création : 16/11/1999.