Abstract
7 “probable” cases of DILI. A single agent was implicated in 84% of cases. Non-prescription medications accounted for 68% of cases. 40% of cases were due to Traditional Chinese Medicines (TCM). Indications for TCM administration include hypertension, joint pain, general well-being & weight loss. Paracetamol was the causative agent in 20%. Anti-tuberculosis drugs made up 66% of the implicated antimicrobial drugs. Mean peak serum biochemistries were: ALT 1998; total bilirubin 283.3, INR 4.4. There were 15 (60%) hepatocellular, 5 (20%) cholestatic, and 5 (20%) mixed pattern of injury. Patients with a mixed pattern had the highest mortality. Mean MELD score was 33. Molecular Adsorbent Recirculating System (MARS) was used as a bridge to transplant in 50% of the patients. Only 16% underwent liver transplantation. Median survival 14(±2) days & In-hospital mortality was 44%. Transplantfree survival was 40%. Conclusion: DILI has a different aetiology and severity profile in Asia compared with the West. TCMs were the most commonly implicated drug. DILI accounted for 55.6% of patients with acute liver failure and is associated with significant mortality.
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