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Læknablaðið - 15.03.2010, Page 34

Læknablaðið - 15.03.2010, Page 34
F R Æ Ð I G REINAR Y F I R L I T 32. Kaplowitz N. Idiosyncratic drug hepatotoxicity. Nat Rev Drug Discov 2005; 4: 489-99. 33. Björnsson E. Hepatotoxicity associated with antiepileptic drugs. Acta Neurol Scand 2008; 118: 281-90. 34. Liu ZX, Govindarajen S, Kaplowitz N. Innate immune sys- tem plays a critical role in determining the progression and severity of acetaminophen (paracetamol) hepatotoxicity. Gastroenterology 2004; 127:1760-4. 35. Watkins PB, Seef LB. Drug-induced liver injury: summary of a single topic research conference. Hepatology 2006; 43: 618- 31. 36. Aithal GP, Ramsey L, Daly AK, et al. Hepatic adducts, cir- culating antibodies, and cytokine polymorphism in patients with diclofenac associated hepatotoxicity. Hepatology 2004; 39:1430-40. 37. Zimmerman ]H, Maddrey WC. Acetaminophen (paracetamol) hepatotoxicity with regular intake of alko- hol: analysis of instances of therapeutic misadventure. Hepatology 1995; 22: 767-73. 38. Schmidt LE, Dalhoff K, Poulsen HE. Acute versus chronic alcohol consumption in acetaminophen-induced hepatotox- icity. Hepatology 2002; 35: 876-82. 39. Shayiq RM, Roberts DW, Rothstein K, et al. Repeat exposure to incremental doses of acetaminophen provides protection against acetaminophen-induced lethality in mice: an expla- nation for high acetaminophen dosage in humans without hepatic injury. Hepatology 1999; 29:451-63. 40. Bjömsson E. The natural history of drug-induced liver injury. Semin Liver Dis 2009; 29: 357-63. 41. Senior JR. Regulatory perspectives. In Drug-induced liver disease. Kaplowitz N and DeLeve LD, eds. Marcel Dekker, New York 2003: 739-54. 42. Bjömsson E, Kalaitzakis E, Av Klinteberg V, Alem N, Olsson R. Long-term follow-up of patients with mild to moderate drug-induced liver injury. Aliment Pharmacol Ther 2007; 26: 79-85. 43. Aithal PG, Day CP. The natural history of histologically pro- ved drug induced liver disease. Gut 1999; 44: 731-5. 44. Lee WM, Hynan LS, Rossaro L, et al. Intravenous N-acetylcysteine improves transplant-free survival in early stage non-acetaminophen acute liver failure. Gastroenterology 2009; 137:856-64. >- CC < 2 2 D (0 X w -I o z UJ Drug-induced liver injury Drug-induced liver injury (DILI) is a well known adverse reaction of many drugs. Direct toxic liver damage is associated with paracetamol toxicity whereas most other drugs causing liver damage have an unpredictable or idiosyncratic pattern of injury. Although idiosyncratic liver injury was initially thought to be dose independent, it has been shown that many drugs leading to idiosyncratic injury have a dose dependent component. Physicians need to bear in mind DILI in ali patients who present with Bjornsson ES. Drug-induced liver injury. Icel J Med 2010; 96: 167-74 Key words: Drug-induced liverinjury Correspondence: EinarS. Björnsson, einarsb@iandspitati.is symptoms or signs of liver dysfunction. Clinically and histologically DILI can mimick any known liver disease and there are no pathognomonic histological features of DILI. The diagnosis is one of exclusion. In patients with a high clinical suspicion of DILI the causative drug need to be discontinued and patients with jaundice and/or coagulopathy have to be hospitalized and some cases considered for a liver transplantation. Barst: 16. október 2009, - samþykkt til birtingar: 4. desember 2009 Hagsmunatengsl: Engin 1 82 LÆKNAblaðið 2010/96

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