Comparison of clinical characteristics between the children and adults patients with drug-induced liver injury
10.3760/cma.j.issn.1008-5734.2014.05.004
- VernacularTitle:儿童与成年患者药物性肝损伤临床特征比较
- Author:
Shuzhen WANG
1
;
Hui LIU
1
;
Junfu ZHENG
1
;
Xin ZHANG
1
;
Bing LI
1
;
Lei LI
1
;
Huiguo DING
1
Author Information
1. 100069首都医科大学附属北京佑安医院肝病消化中心
- Publication Type:Journal Article
- Keywords:
Drug-induced liver injury;
Child;
Adult;
Disease attributes
- From:
Adverse Drug Reactions Journal
2014;(5):269-273
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical characteristics between the children and adults patients with drug-induced liver injury( DILI). Methods "Drug-induced liver injury" was selected as the key word and all the medical records in Beijing You'an Hospital Medical Records Management Center from February 2002 to June 2011 were collected. The patients who were ≤14 years were enrolled into the child group. The patients who were ≥15 years were enrolled into the adult group. The medical records of patients in the two groups were collected and analyzed retrospectively. The main analysis parameters included use of medication,clinical manifestation,and clinical pathological classification of DILI. Results The main drugs which can cause DILI in child group were antibacterial drugs( 13 cases,42%),traditional Chinese medicines(9 cases,29%),and antipyretic analgesics(6 cases,19%). The main drugs which can cause DILI in the adult group were traditional Chinese medicines( 79 cases,69%),antipyretic analgesics(12 cases,11%),and antibacterial drugs(8 cases,7%). Twenty-six patients(84%)in the child group and 114 patients(100%)in the adult group developed weak,loss of appetite,aversion to fats, nausea,vomiting and yellow urine 3 to 90 days[mean(18 ± 15)days]and 5 to 90 days[mean(30 ± 20) days] after drug admission, respectively. Part of patients developed fever, erythema and increased eosinophils. There were no significant differences in the levels of serum alanine transaminase( ALT ), aspartate aminotransferase( AST),and glutamyltranspetidase between the two groups. But the level of serum alkaline phosphatase(ALP)in the child group was higher than that in the adult group(P<0. 05). The number of mixed DILI,hepatocellular DILI and cholestasis DILI were 15(48. 4%),8(25%)and 8 (25%)cases in 31 patients in the child group,respectively. The number of hepatocellular DILI,mixed DILI,and cholestasis DILI were 69(60. 5%),26(22. 8%)and 19(16. 7%)cases in 114 patients in the adult group,respectively. The proportion of mixed DILI in child group was significantly higher than that in the adult group(P<0. 01). The proportion of hepatocellular DILI in the child group was significantly lower than that in the adult group(P<0. 01). The drugs were withdrawn immediately after the symptoms of DILI appeared in the patient in the two groups. All the patients in the adult group and 27 children in the child group were improved and discharged. There were 2 cases with depravation of primary diseases,1 case discharged himself and 1 case died due to hepatic failure in the child group Conclusions The main drugs causing DILI are different in children and adult;in children,antibacterial drugs ,while in adults traditional Chinese medicine mainly. The mainly liver injury type in children is mixed DILI. The mainly liver injury type in adults is hepatocellular DILI. It should be vigilant towards DILI when the child or adult treated with antibiotics or traditional Chinese medicine.
