Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/821
Title: Assessment of drug-induced hepatotoxicity in clinical practice: a challenge for gastroenterologists.
Authors: Andrade Bellido, Raul-Jesús
Robles Díaz, Mercedes
Fernández-Castañer, Alejandra
López-Ortega, Susana
López-Vega, María-Carmen
Lucena González, María-Isabel
metadata.dc.contributor.authoraffiliation: [Andrade Bellido,RJ; Robles Díaz,M; Fernández-Castañer,A; López-Ortega,S; López-Vega,MC] Liver Unit, Gastroenterology Service, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Andrade Bellido,RJ; Robles Díaz,M; Fernández-Castañer,A; López-Ortega,S; López-Vega,MC] Liver Unit, Gastroenterology Service, School of Medicine, Málaga, Spain. [Lucena González,MI] Clinical Pharmacology Service, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Lucena González,MI] Clinical Pharmacology Service, School of Medicine, Málaga, Spain.
Keywords: Drug-induced hepatotoxicity;Causality assessment;Diagnostic Algorithms;Clinical scales;Enfermedad Hepática Inducida por Drogas;Algoritmos;Hepatopatías;Quimioterapia;Gastroenterología;Escalas Clínicas
metadata.dc.subject.mesh: Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy
Medical Subject Headings::Diseases::Digestive System Diseases::Liver Diseases::Drug-Induced Liver Injury
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Disciplines and Occupations::Health Occupations::Medicine::Internal Medicine::Gastroenterology
Medical Subject Headings::Phenomena and Processes::Mathematical Concepts::Algorithms
Medical Subject Headings::Diseases::Digestive System Diseases::Liver Diseases
Issue Date: 21-Jan-2007
Publisher: Baishideng Publishing Group
Citation: Andrade Bellido RJ, Robles Díaz M, Fernández-Castañer A, López-Ortega S, López-Vega MC, Lucena González MI. Assessment of drug-induced hepatotoxicity in clinical practice: a challenge for gastroenterologists. World J. Gastroenterol.. 2007; 13(3):329-40
Abstract: Currently, pharmaceutical preparations are serious contributors to liver disease; hepatotoxicity ranking as the most frequent cause for acute liver failure and post-commercialization regulatory decisions. The diagnosis of hepatotoxicity remains a difficult task because of the lack of reliable markers for use in general clinical practice. To incriminate any given drug in an episode of liver dysfunction is a step-by-step process that requires a high degree of suspicion, compatible chronology, awareness of the drug's hepatotoxic potential, the exclusion of alternative causes of liver damage and the ability to detect the presence of subtle data that favors a toxic etiology. This process is time-consuming and the final result is frequently inaccurate. Diagnostic algorithms may add consistency to the diagnostic process by translating the suspicion into a quantitative score. Such scales are useful since they provide a framework that emphasizes the features that merit attention in cases of suspected hepatic adverse reaction as well. Current efforts in collecting bona fide cases of drug-induced hepatotoxicity will make refinements of existing scales feasible. It is now relatively easy to accommodate relevant data within the scoring system and to delete low-impact items. Efforts should also be directed toward the development of an abridged instrument for use in evaluating suspected drug-induced hepatotoxicity at the very beginning of the diagnosis and treatment process when clinical decisions need to be made. The instrument chosen would enable a confident diagnosis to be made on admission of the patient and treatment to be fine-tuned as further information is collected.
Description: Editorial; Research Support, Non-U.S. Gov't; Review;
URI: http://hdl.handle.net/10668/821
metadata.dc.relation.publisherversion: http://www.wjgnet.com/1007-9327/full/v13/i3/329.htm
ISSN: 2219-2840 (Online)
1007-9327 (Print)
Appears in Collections:01- Artículos - Hospital Virgen de la Victoria

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