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Related Experiment Videos

Drug-induced acute liver failure.

Dominique Larrey1, Georges-Philippe Pageaux

  • 1Department of Gastroenterology, Hepatology and Liver Transplantation, Hôpital Saint Eloi, Montpellier School of Medicine and INSERM Unit 632, Montpellier, France. d-larrey@chu-montpellier.fr

European Journal of Gastroenterology & Hepatology
|January 28, 2005
PubMed
Summary

Drug-induced liver injury is a severe condition, leading to drug withdrawal and significant mortality. Early detection and intervention, such as stopping suspect drugs or administering N-acetylcysteine for paracetamol overdose, are crucial for managing acute liver failure.

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Area of Science:

  • Hepatology
  • Clinical Pharmacology
  • Toxicology

Background:

  • Drug-induced liver injury (DILI) is a major cause of acute liver failure and drug withdrawal.
  • The incidence of DILI is estimated at 14 per 100,000 population in Western countries.
  • Drugs account for 10-52% of acute liver failure cases.

Purpose of the Study:

  • To review the impact and management of drug-induced acute liver failure.
  • To highlight the significance of paracetamol (acetaminophen) and other drug toxicities.
  • To discuss prognosis, prevention, and treatment strategies for DILI.

Main Methods:

  • Literature review of drug-induced hepatotoxicity.
  • Analysis of incidence, mortality, and etiological factors of acute liver failure.

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  • Summary of current treatment guidelines and recommendations.

    • Main Results:

    • Paracetamol (acetaminophen) is the leading cause of liver failure in Western countries.
    • Non-paracetamol drugs at therapeutic doses contribute significantly to liver failure.
    • Spontaneous mortality rates are high, ranging from 32-50% for paracetamol and over 75% for other drugs.
    • Early detection (ALT > 3-5x ULN) and intervention are key.

    Conclusions:

    • Prompt cessation of suspected drugs is recommended upon elevated liver enzymes.
    • N-acetylcysteine is a vital antidote for paracetamol intoxication.
    • Supportive care and consideration for liver transplantation are critical in advanced liver failure.