Drug-Induced Chronic Liver Disease

2015 ◽  
pp. 156-159 ◽  
Author(s):  
F. Schaffner
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Drug Induced

scholarly journals Kratom-Induced Cholestatic Liver Injury and Its Conservative Management

2019 ◽  
Vol 7 ◽  
pp. 232470961983613 ◽  
Author(s):  
Christopher T. Fernandes ◽  
Umair Iqbal ◽  
Sean P. Tighe ◽  
Aijaz Ahmed
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Chronic Liver Disease ◽  
The United States ◽  
Chronic Liver ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Analgesic Effects

Drug-induced liver injury (DILI) is a common cause of hepatotoxicity associated with prescription-based and over-the-counter exposure to medications and herbal supplements. Use of unapproved and inadequately tested herbal supplements can cause DILI. Therefore, thorough history-taking on exposure to herbal supplements must be an integral part of clinical evaluation of DILI. Kratom is an herbal supplement or remedy that has been known for its analgesic effects and has also been used for self-treatment of opiate withdrawals. A 52-year-old man was seen for evaluation of yellow discoloration of the eyes and skin. He reported taking kratom for right shoulder strain for at least a couple of months. On workup, his total bilirubin was noted to be 23.2 mg/dL, which peaked at 28.9 mg/dL. He was noted to have mild elevation of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. Extensive laboratory tests were ordered and known causes of chronic liver disease ruled out. Magnetic resonance imaging of the abdomen was unremarkable without stigmata of portal hypertension or signs of chronic liver disease. He demonstrated no evidence of coagulopathy or hepatic encephalopathy during his illness. He underwent liver biopsy, which demonstrated histologic evidence of acute cholestatic hepatitis highly suspicious of DILI. He was advised to avoid kratom or other herbal supplements in future and prescribed ursodeoxycholic acid with significant improvement in his liver chemistries. Kratom is associated with significant liver enzymes derangements leading to DILI. Kratom is not approved for use in the United States and should be avoided.

Drug-Induced Liver Disease and Drug Use Considerations in Liver Disease

2009 ◽  
Vol 22 (3) ◽  
pp. 278-289 ◽  
Author(s):  
Jiwon W. Kim ◽  
Paula V. Phongsamran
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Hepatic Metabolism ◽  
The United States ◽  
Chronic Liver ◽  
Drug Induced ◽  
Underlying Liver Disease ◽  
Drug Dosing ◽  
Clinical Presentations ◽  
Cirrhotic Patients

Chronic liver disease encompasses a large number of hepatic disorders. One of the most important etiologies of liver disease is drug-induced liver disease, which is the leading cause of liver failure in patients referred for liver transplantation in the United States. Drug-induced liver disease can present in all forms of acute and chronic liver disease with highly variable clinical presentations. There is no effective treatment for most drug-induced liver disease and the recognition and prevention of drug-induced liver disease remain the most important management strategy. Drug dosing in patients with liver disease represents an even more challenging task to clinicians, as there is only scant information on biomarkers that can be used to predict the pharmacokinetic changes of drugs in patients with underlying liver disease. Several factors contribute to alterations in drugs metabolism and clearance in cirrhotic patients, including the severity of the liver disease and the metabolic pathways of each individual drug. Only general guidelines on dosage adjustment in patients with hepatic impairment are available. When drugs with extensive hepatic metabolism are required in patients with preexisting liver disease, benefit of therapeutic effect must be evaluated against the risk of toxicity, and the drugs must be initiated with extreme caution with appropriate dosage reduction.

scholarly journals Drug-Induced Chronic Liver Disease

1977 ◽  
Vol 72 (6) ◽  
pp. 1348-1353 ◽  
Author(s):  
Willis C. Maddrey ◽  
Join K. Boitnott
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Drug Induced

DRUG-INDUCED CHRONIC LIVER DISEASE

1998 ◽  
Vol 2 (3) ◽  
pp. 501-522 ◽  
Author(s):  
Doris B. Strader ◽  
Leonard B. Seeff
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Drug Induced
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