OP-3 CLINICAL PRESENTATION AND CAUSATIVE AGENTS OF IDIOSYNCRATIC DRUG-INDUCED LIVER INJURY IN URUGUAY: FIRST DECADE OF EXPERIENCE.

Abstract

Introduction and Objectives: Drug-induced liver injury (DILI), usually considered rare, represents a unique challenge. The creation of DILI registries has improved epidemiological understanding and enhanced awareness, which in the absence of specific biomarkers, is essential for a more accurate diagnosis. This study aimed to present a complete analysis of 147 Uruguayan cases with DILI enrolled in the LATINDILI Registry over ten years. Materials and Methods: Uruguayan patients enrolled in the LATINDILI registry during the last decade were analyzed regarding latency, pattern, severity, evolution, and type of drugs incriminated. Baseline characteristics were described using mean, median, and percentages. Results: Out of 158 episodes presenting suspected DILI, eleven were excluded for alternative diagnoses or insufficient data, and 147 were finally enrolled into the registry from 2011 to 2021. The mean age was 53 years and 60% were females. Jaundice was present in 55% of the cases; the mean latency was 75 days (1-720). Total bilirubin ranged from 0.19 to 33 mg/dl (mean 4.7), ALT from 32 to 6000 UI/L (mean 630), and AP was between 60 and 3327 UI/L with a median of 520. The hepatocellular injury was the most frequent pattern (58%), and anti-infectives were the most common causative drug class (28%), followed by antineoplastic agents (16%). Amoxicillin clavulanate was the most frequent drug across all patterns of injury. Hospital admission was seen in 51% and complete recovery before one year of follow-up in 73% (10% lost of follow-up). Table 1 describes the demographics, clinical and laboratory parameters according to the type of damage. Conclusions: This prospective series is the first approximation of the epidemiology of DILI in Uruguay. Beyond its contribution to the LATINDILI registry, it is a priceless tool to identify/highlight local risk factors, causative drugs, and clinical signatures and can impact fostering DILI recognition.