Drug-induced liver injury: an analysis of 384 cases

Abstract

Objective To analyze the causes, clinical characteristics and treatment outcomes of drug-induced liver injury (DILI). Methods The general information, medication history, clinical classification, grade of liver injury and clinical outcome of 384 patients with drug-induced liver injury admitted in Changjiang River Hospital during January 2014 to December 2018 were retrospectively analyzed. Results Among 384 cases of drug-induced liver injury, there were 191 cases aged ≥60 (49.7%). The top three drugs inducing liver injury were antibiotics, anti-tuberculosis drugs and immune-enhancing Traditional Chinese Medicine (TCM) decoction, accounting for 40.6%(156/384), 20.3%(78/384)and 15.6% (60/384), respectively. In 60 cases of TCM decoction-induced liver injury, 39 cases were cholestatic liver injury (65.0%,39/60), 11 cases were hepatocellular liver injury (18.3%,11/60) and 10 were mixed liver injury (16.7%,10/60) (χ2=40.650, P<0.01). In 44 cases of DILI caused by anti-cancer chemotherapeutic drugs, 25 cases were hepatocellular liver injury (56.8%,25/44), 12 cases were cholestatic liver injury (27.3%,12/44) and 7 cases were mixed liver injury (15.9%,7/44) (χ2=17.659, P<0.01). The proportion of treatment failure in patients with grade 4 liver injury was 5/10 and the proportion of mortality in patients with grade 5 liver injury was 8/8, which were significantly higher than those with lower grade liver injury (χ2=157.218, P<0.01; χ2=320.917, P<0.01). Conclusion The development of drug-induced liver injury and its clinical classification are related to the types of drug, and the prognosis of drug-induced liver injury is depended on the degree of liver injury. Key words: Drug-induced liver injury; Anti-bacterial agents; Antitubercular agents; Drugs, Chinese herbal