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Drug-Induced Acute Liver Failure.
Shahid Habib1, Obaid S Shaikh2
1Department of Medicine, Southern Arizona Veterans Affairs Healthcare System 3601 S 6th Avenue, Tucson, AZ 85723 USA.
Clinics in Liver Disease
|November 16, 2016
Summary
Drug-induced acute liver failure (ALF) disproportionately affects women and nonwhites, often caused by antimicrobials. While intensive care has improved outcomes, liver transplantation remains critical for survival.
Area of Science:
- Hepatology
- Toxicology
- Internal Medicine
Background:
- Drug-induced acute liver failure (ALF) is a severe condition with significant mortality.
- Certain demographics, including women and nonwhite individuals, are disproportionately affected.
- Common causative agents include antimicrobials, antiepileptics, and statins.
Purpose of the Study:
- To summarize the epidemiology, causes, complications, and management of drug-induced ALF.
- To highlight the patterns of liver injury and critical complications associated with drug-induced ALF.
Main Methods:
- Review of existing literature on drug-induced acute liver failure.
- Analysis of patient demographics, causative agents, injury patterns, and clinical outcomes.
- Evaluation of current management strategies, including intensive care and liver transplantation.
Main Results:
- Antimicrobials are the most frequent cause of drug-induced ALF.
- Hepatocellular injury is the predominant pattern observed in these patients.
- Cerebral edema and intracranial hypertension are the most life-threatening complications.
Conclusions:
- Despite advances in intensive care, drug-induced ALF carries substantial mortality without timely liver transplantation.
- Liver-assist devices offer a potential bridge to transplantation or spontaneous recovery.
- Understanding causative agents and risk factors is crucial for prevention and management.
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