P-95 HEPATOXICITY FOR DRUGS AND HERBAL PRODUCTS IN INPATIENTS FROM A UNIVERSITY HOSPITAL, BRAZIL

Abstract

Introduction: Drug induce liver injury (DILI) and Herbal Induce Liver Injrury (HILI) are a frequent complaint in clinical practice. These are manifested with alterations at the liver profile, and most of the time these are underdiagnosed. Aims: To study the prevalence and clinic presentation of DILI/ HILI in 5 clinical inpatient rooms at a University Hospital. Methods: Prospective cohort study with patients admitted between July and October 2020, in 5 inpatient rooms of the University Hospital of Bahia. RUCAM causality score was used to determine DILI/HILI, tests were performed to rule out another etiologies and to confirm DILI Results: Total sample of 400 patients hospitalized for various causes, DILI/HILI was diagnosed in 10 patients: 2.5% of all the sample. Etiology: 90 % allopathic drugs: Clopromazine, Cephalexin, Mesalazine, Etrolizumab, Azatriopine associated with Hydrochloroquine, Tretinoin with Variconazole, Phenytoin, and RIPE (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol). Natural products were 10 %: Peumus boldus. Clinical symptoms: 100 % had jaundice; 50 % nausea; 25 % choluria; 25 % fecal acholia; 25 % vomiting; 25 % pruritus; 25 % insomnia; 25 % asthenia; 25 % arthralgia and 25 % eosinophilia. The mean time to resolution of symptoms was 18.5 days; the mean ALT level was 262.6; AST was 216.8 and AF was 1287, without severe cases. Conclusions: The prevalence of DILI/ HDS in the inpatients was 2.5%, considered high, demonstrating the importance of the active search of these cases for its diagnosis.