scholarly journals Potentially hepatotoxic drugs are still being prescribed to liver disease patients under tertiary care: it is time to say enough

2021 ◽  
Vol 5 (4) ◽  
pp. 279-286
Author(s):  
Rodrigo Dorelo ◽  
Samantha T.A. Barcelos ◽  
Magela Barros ◽  
Valeria Elustondo ◽  
Ysela Y.P. Pérez ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Liver Enzymes ◽  
Tertiary Care ◽  
University Hospital ◽  
Decompensated Cirrhosis ◽  
Drug Induced ◽  
Alcoholic Fatty Liver ◽  
Drug Induced Liver Injury ◽  
Elevated Liver Enzymes

Introduction and aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital. Materials and methods: Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure. Results: From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death. Conclusion: PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk.

scholarly journals Drug-induced fulminant hepatic failure in pregnancy

2015 ◽  
Vol 8 (4) ◽  
pp. 190-192 ◽  
Author(s):  
Tabassum Firoz ◽  
Douglas Webber ◽  
Hilary Rowe
Keyword(s):  
Liver Disease ◽  
Liver Failure ◽  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
Liver Enzymes ◽  
Abnormal Liver Function ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Elevated Liver Enzymes ◽  
In Pregnancy

Liver disease in pregnancy can be classified as predating, co-incidental or unique to pregnancy. Medications are often overlooked as a significant cause of liver disease. We present the case of a 39-year-old patient who presented at 20 weeks with jaundice, elevated liver enzymes, and abnormal liver function progressing eventually to fulminant hepatic failure. The patient was on methyldopa and labetalol from 12 weeks’ gestational age. Liver biopsy was consistent with drug-induced liver injury. Both methyldopa and labetalol have been associated with hepatotoxicity including liver failure. This case highlights the importance of including medications as a cause of liver failure in pregnant patients.

Hematological, Biochemical and Etiological factors of Chronic Liver Disease in a tertiary care Hospital of Lahore

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Sami Ullah Mumtaz ◽  
Amna Akbar ◽  
Humaira Waseem ◽  
Tayyeba Komal ◽  
Somia Iqtadar ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatic Encephalopathy ◽  
Hepatitis C ◽  
Chronic Liver Disease ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Chronic Liver ◽  
Care Hospital ◽  
Alcoholic Fatty Liver ◽  
Etiological Factors

Chronic Liver Disease (CLD) progresses from hepatocyte inammation to brosis, regeneration, cirrhosis and in some cases to Hepatocellular Carcinoma (HCC). In general, the main etiologies of Liver Cirrhosis (LC) are viral infections (hepatitis C and B viruses), chronic alcohol abuse and Non-Alcoholic Fatty Liver Disease (NAFLD), including Non-Alcoholic Steato Hepatitis (NASH). Major complications of CLD are ascites, upper gastrointestinal bleeding, jaundice (acute or chronic) and hepatic encephalopathy. Abstract:Study Design: Cross-sectional.Conclusions: This study assesses the etiological factors and complications of CLD in a tertiary care hospital of Lahore, Pakistan. Objectives: Methods: Study was carried out in indoor and Accident & Emergency Departments of Mayo Hospital Lahore. 100 clinically diagnosed CLD cases were chosen through “Convenient Sampling” technique during 3 months. Observations: Most common complications of CLD were upper GI variceal Bleeding (48%) & hepatic encephalopathy (34%) and acute or chronic hepatitis (AVH) (33%). Other less common complications observed were hepatorenal syndrome (10%), Spontaneous bacterial peritonitis (15%), Ascites (5%) and HCC (10%). Hepatitis C was found as main etiological factor of CLD. Bleeding and hepatic encephalopathy are the common complications. Awareness programmes regarding CLD and its complications are mandatory in our society to improve human health.

scholarly journals Epidemiology of Chronic Hepatitis C Infections at a Tertiary Care Centre in Oman

2018 ◽  
Vol 17 (4) ◽  
pp. 404 ◽  
Author(s):  
Said A. Al-Busafi ◽  
Halima Al-Shuaili ◽  
Heba Omar ◽  
Haifa Al-Zuhaibi ◽  
L. Jeyaseelan ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
University Hospital ◽  
Decompensated Cirrhosis ◽  
Care Hospital ◽  
Early Screening

Objectives: Chronic hepatitis C (CHC) is a leading cause of liver cirrhosis and hepatocellular carcinoma (HCC) worldwide. However, there is a lack of data regarding the epidemiology of CHC in Oman. This study aimed to describe the clinicopathological characteristics and outcomes of CHC-infected patients at a tertiary care hospital in Oman. Methods: This retrospective descriptive hospital-based study included all CHC-infected patients who presented to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman, between January 2010 and December 2015. The baseline demographic, clinical, laboratory and radiological data of the patients were analysed. Results: A total of 603 CHC-infected patients were identified during the study period; of these, 65.8% were male and the mean age was 44.8 ± 16.5 years. The main risk factors associated with CHC infection were intravenous drug abuse (23.9%) and a history of blood transfusions (20.7%). The most prevalent virus genotypes were 1 and 3 (44.0% and 35.1%, respectively). Upon initial presentation, 33.0% of the cohort had liver cirrhosis; of these, 48.7% had decompensated cirrhosis and 23.1% had HCCs. Liver transplantation was only performed for 7.5% of the cirrhosis patients, mostly as a curative treatment for HCC. Conclusion: The implementation of national policies to prevent hepatitis C transmission and encourage the early screening of at-risk patients is recommended to reduce the burden and consequences of this disease in Oman.

scholarly journals Anastrozole-induced liver injury after a prolonged latency: a very rare complication of a commonly prescribed medication

2019 ◽  
Vol 12 (11) ◽  
pp. e231741 ◽  
Author(s):  
Chencheng Xie ◽  
Hafez Mohammad Ammar Abdullah ◽  
Mohamed Abdallah ◽  
Erin Quist ◽  
Mumtaz Niazi
Keyword(s):  
Liver Injury ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Assessment Method ◽  
Drug Induced ◽  
Serious Adverse Events ◽  
Drug Induced Liver Injury ◽  
Elevated Liver Enzymes ◽  
Safe Side ◽  
Prolonged Latency

Anastrozole is an aromatase inhibitor that has been used more frequently over the last decade especially for oestrogen receptor-positive breast cancer. It has a relatively safe side effect profile. However, occasionally it has been associated with serious adverse events. Here, we present the case of a 58-year-old woman who presented with significantly elevated liver enzymes 4 years after starting anastrozole. She was not taking any other medications and an extensive workup did not reveal any other cause for her liver injury. The patient’s liver enzymes normalised after discounting the anastrozole. She scored 4 on the updated Roussel Uclaf Causality Assessment Method grading system which was possible for drug-induced liver injury. A review of the literature revealed six prior cases of anastrozole-related liver injury. Anastrozole should be considered as a possible culprit in patients who develop an unexplained acute liver injury.

scholarly journals Nutraceutical Properties of Polyphenols against Liver Diseases

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3517
Author(s):  
Jorge Simón ◽  
María Casado-Andrés ◽  
Naroa Goikoetxea-Usandizaga ◽  
Marina Serrano-Maciá ◽  
María Luz Martínez-Chantar
Keyword(s):  
Liver Disease ◽  
Liver Diseases ◽  
Dietary Habits ◽  
Structural Diversity ◽  
The Body ◽  
Attractive Alternative ◽  
Drug Induced ◽  
Alcoholic Fatty Liver ◽  
Drug Induced Liver Injury

Current food tendencies, suboptimal dietary habits and a sedentary lifestyle are spreading metabolic disorders worldwide. Consequently, the prevalence of liver pathologies is increasing, as it is the main metabolic organ in the body. Chronic liver diseases, with non-alcoholic fatty liver disease (NAFLD) as the main cause, have an alarming prevalence of around 25% worldwide. Otherwise, the consumption of certain drugs leads to an acute liver failure (ALF), with drug-induced liver injury (DILI) as its main cause, or alcoholic liver disease (ALD). Although programs carried out by authorities are focused on improving dietary habits and lifestyle, the long-term compliance of the patient makes them difficult to follow. Thus, the supplementation with certain substances may represent a more easy-to-follow approach for patients. In this context, the consumption of polyphenol-rich food represents an attractive alternative as these compounds have been characterized to be effective in ameliorating liver pathologies. Despite of their structural diversity, certain similar characteristics allow to classify polyphenols in 5 groups: stilbenes, flavonoids, phenolic acids, lignans and curcuminoids. Herein, we have identified the most relevant compounds in each group and characterized their main sources. By this, authorities should encourage the consumption of polyphenol-rich products, as most of them are available in quotidian life, which might reduce the socioeconomical burden of liver diseases.

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