Clinical features of drug-induced liver injury: a review of Chinese literatures 2007–2011

Abstract

Objective To analyze the clinical characteristics of drug-induced liver injury(DILI) from Chinese literatures published in Chinese Periodical Full-text Database (CNKI) from 2007 to 2011. Methods Using drug-induced liver injury as key words, the literatures in CNKI were searched, and the data of age, gender, medication, clinical manifestation and prognosis were analyzed. Results In search of CNKI, 281 literatures were collected; finally 111 relevant papers were obtained. Total 10 693 cases of DILI were included with a male/female ratio of 1.14∶1 and a mean age of 45.6 y ranging from 7 months to 93 y. Among 1093 cases with the age grouped, the highest incidence of DILI was in age 41-60 y(38.52%)and 20.68% patients were over 60 y. Among 6592 cases with clinical manifestation recorded, 43.51% patients were asymptomatic and abnormal liver function was detected in health check-up; and others presented non-specific gastrointestinal symptoms, including fatigue, nausea, vomiting and jaundice. In 9340 cases with medication recorded, the 6 most common drugs inducing DILI were antituberculotics (32.74%), Chinese herbs(22.12%), antibiotics(9.18%), antineoplastics(6.34%), NSAIDs (4.80%)and antithyroid drugs(4.37%). The most common type of toxicity was hepatocellular injury(63.66%, 4438/6971). In general the prognosis was good with a fatality rate of 1.67%. Conclusions Antituberculotics and Chinese herbs are the main causes of DILI. Some DILI patients have occult onset and others have nonspecific gastrointestinal symptoms. Most patients have good prognosis if they are treated timely. Key words: Hepatitis, chronic, drug-induced; Review literature; Retrospective studies