Survey of the drug-induced liver injury cases for the past 10 years at Department of Medicine, Teikyo University Hospital

Background : Recently, the cases of drug-induced liver injury have been increasing due to aging and the increase of kinds of the drug and patients taking many agents. In the present study, we surveyed the cases of drug-induced liver injury at Teikyo University Hospital. Methods : We surveyed the cases that were diagnosed as drug-induced liver injury and admitted to Teikyo University Hospital in 1997-2006. The type of liver injury, causal drugs and the utility of the diagnostic scale for drug-induced liver injury of the DDW-J 2004 were examined. Results : Eighty two cases (32 male and 50 female) were classified to 54 cases (66 %) of hepatocellular type, 18 cases (22 %) with mixed type and 10 cases (12 %) with cholestatic type according to the type of liver injury. The cases with serum levels of alanine aminotransferase more than 500 IU/l were the 50 cases (61 %), and those more than 2,000 IU/l were 15 cases (18 %). The case with serum levels of total bilirubin more than 10 mg/dl were 15 cases (18 %). Using the diagnostic scale, 68 cases (83 %) were classified to 'highly probable' (more than 5 points), and 79 cases (96 %) were classified either to 'highly probable' or 'possible' (more than 3 points). Causal drugs were as follows ; 15 cases by anti-infectious drugs, 14 cases by anti-inflammatory drugs, 12 cases by anti-platelet drugs, 8 cases by over the counter drugs for the common cold, 6 cases by drugs for the hyperlipidemia. Conclusions : Because we surveyed only the cases admitted due to the possibility of drug-induced liver injury, many cases presented marked hepatocelullar damage with symptoms such as general malaise or jaundice. In addition, the diagnostic scale for drug-induced liver injury was shown to be useful to diagnose these patients.