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KMID : 0604620060130010037
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Dongguk Journal of Medicine
2006 Volume.13 No. 1 p.37 ~ p.44
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A Clinical Study of Drug-induced Liver Injury
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Suh Jeong-Ill
Kim Sung-Wook
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Abstract
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Drug-induced liver injury is a serious and growing problem. Nevertheless, little is known about the prevalence and clinical manifestation of drug-induced acute liver injury. We examined the epidemiological characteristics, clinical symptoms, and evolution of drug-induced liver injury over the last 4 years. From May 2002 to December 2005, 40 patients diagnosed with having drug-induced liver injury were studied retrospectively analyzing epidermilological data (age, sex, taken medicine, clinical symptom and course, the pattern of hepatitis based on R ratio). And we compared the assessments of drug-induced liver injury obtained with 2 clinical scales for causality assessment in hepatotoxicity, the Roussel Uclaf Causality Assessment Method (RUCAM) scale and Maria and Victorino (M&V) scale. A total of 40 patients were diagnosed as having drug-induced liver injury, 18 men (45%) and 22 women (55%), mean age 51.2 years, of which 72.5% were older than 40 years. The most frequent cause of drug-induced liver injury was due to antituberculosis drugs (13 cases). In the pattern of liver injury, hepatocellular liver injury were 28 cases (70%), occurred the highest prevalence, mixed type were 9 cases (22.5%) and cholestatic liver injury were 3 case (7.5%). All most patients made a complete recovery after withdrawal of the suspected causal drugs. Between two clinical scale, best correlation were only 2 cases (5%), therefore, their concordance rate was very low. The incidence of drug-induced liver injury is higher in patients over 40 years of age, it being more common in female. Moreover, nationwide large scaled prevalence study is needed. And, a new suitable clinical scale for causality assessment in hepatotoxicity in our country that had high prevalence of liver injury caused by drug is needed.
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KEYWORD
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drug, liver injury
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