Journal of Investigative Medicine High Impact Case Reports (Mar 2018)

Drug-Induced Liver Injury: An Institutional Case Series and Review of Literature

  • Vijay Gayam MD,
  • Mazin Khalid MD,
  • Binav Shrestha MD,
  • Muhammad Rajib Hossain MD,
  • Sumit Dahal MD,
  • Pavani Garlapati MD,
  • Arshpal Gill BHsc,
  • Amrendra Kumar Mandal MD,
  • Ruby Sangha BSc

DOI
https://doi.org/10.1177/2324709618761754
Journal volume & issue
Vol. 6

Abstract

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Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the USA. DILI can be broadly classified as Intrinsic and Idiosyncratic. Identifying predictors and at-risk patients are challenging but can have a substantial clinical implication. This case report series demonstrates the importance of valproic acid, fluconazole, and amiodarone as potential hepatoxic agents of drug-induced liver injury leading to acute hepatic failure. The causality in all cases was established by Roussel Uclaf Causality Assessment Method/Council for International Organizations of Medical Sciences score and Naranjo Algorithm. Obesity, hypo-perfusion state, and concurrent hepatotoxic agent might identify at-risk patients. Further studies are required to understand the risk factors.