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Published on: April 28, 2020
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Toxin-induced hepatic injury.
Annette M Lopez1, Robert G Hendrickson
1Department of Emergency Medicine, Oregon Health and Science University, 3181 South West, Sam Jackson Park Road, CSB-550, Portland, OR 97239, USA; Medical Toxicology, Oregon Health and Science University, 3181 South West Sam Jackson Park Road, CSB-550, Portland, OR 97239, USA.
Emergency Medicine Clinics of North America
|November 27, 2013
Summary
Drug-induced liver injury can range from mild abnormalities to acute liver failure, often caused by acetaminophen and ethanol. Identifying toxin exposure and discontinuing the agent are key to managing hepatic damage.
Area of Science:
- Hepatology
- Toxicology
- Internal Medicine
Background:
- Toxins including pharmaceuticals, herbals, foods, and supplements can cause liver damage.
- This hepatic damage can manifest as nonspecific symptoms with abnormal liver tests or progress to acute liver failure.
- Acetaminophen and ethanol are the most frequent causes of severe toxin-induced hepatic injury.
Purpose of the Study:
- To review the incidence, pathophysiology, diagnosis, and management of toxin-induced hepatic injury.
- To provide an in-depth examination of common hepatic toxins.
- To highlight the importance of patient history in identifying toxin exposure.
Main Methods:
- Literature review of toxin-induced hepatic injury.
- Analysis of diagnostic approaches for liver dysfunction.
- Evaluation of management strategies for hepatic damage.
Main Results:
- Extensive patient history is crucial for identifying toxin exposure and excluding other causes of liver dysfunction.
- Discontinuing the offending agent is the primary management strategy for most toxin exposures.
- Patients with acute liver failure may require transfer to a transplant service.
Conclusions:
- Toxin-induced hepatic injury is a significant clinical concern with a spectrum of severity.
- Prompt identification of the causative agent and its removal are paramount for patient recovery.
- Understanding the pathophysiology and management of hepatic toxins is essential for effective patient care.
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