Portal de Periódicos da CAPES

Etiology of New-Onset Jaundice: How Often Is It Caused by Idiosyncratic Drug-Induced Liver Injury in The United States?

2006; Lippincott Williams & Wilkins; Volume: 102; Issue: 3 Linguagem: Inglês

10.1111/j.1572-0241.2006.01019.x

1572-0241

Raj Vuppalanchi, Suthat Liangpunsakul, Naga Chalasani,

Liver Disease and Transplantation

The epidemiology of acute drug-induced liver injury (DILI) in the United States has not been well studied. We conducted a study of adults with new-onset jaundice at a nonreferral community hospital to better understand the epidemiology of acute DILI.This is a retrospective study of adult outpatients and inpatients (> or =18 yr) with new-onset jaundice over a 5-yr period (1999-2003) at Wishard Memorial Hospital, Indiana. Patients with new-onset jaundice were identified using our electronic medical record system and individual medical records were reviewed to extract the required clinical data. New-onset jaundice was defined as the presence of total serum bilirubin >3 mg/dL in patients without a prior total bilirubin >3 mg/dL.A total of 732 eligible adults constituted our study cohort. Sepsis or altered hemodynamic state resulting in presumed ischemic liver injury is the single most common cause of jaundice (22%). Acute liver disease as a result of nonalcoholic etiologies caused new-onset jaundice in 97 patients (13%), with acute viral hepatitis in 66 patients (9%) and DILI in 29 patients (4%). Most cases of DILI were as a result of acetaminophen toxicity with idiosyncratic DILI occurring in only five patients (0.7%). No mortality was observed at 6 wk in patients who developed idiosyncratic DILI.Idiosyncratic DILI appears to be a rare cause of new-onset jaundice in a community hospital setting.