Mengual-Moreno Edgardo, Lizarzábal-García Maribel, Ruiz-Soler María, Silva-Suarez Niniveth, Andrade-Bellido Raúl, Lucena-González Maribel, Bessone Fernando, Hernández Nelia, Sánchez Adriana, Medina-Cáliz Inmaculada
Invest Clin. 2015 Mar;56(1):3-12.
Drug-induced liver injury (DILI) is an important cause of morbidity and mortality worldwide, with varied geographical differences. The aim of this prospective, descriptive, cross-sectional study was to identify and characterize cases of DILI in a hospital of Zulia state, Venezuela. Thirteen patients with a presumptive diagnosis of DILI attended by the Department of Gastroenterology, Hospital Universitario, Zulia state, Venezuela, from December-2012 to December-2013 were studied. Ibuprofen (n = 3; 23.1%), acetaminophen (n = 3; 23.1), isoniazid (n = 2; 15.4%) and Herbalife products (n = 2; 15.4%) were the main drugs involved with DILI. Acetaminophen and ibuprofen showed a mixed pattern of liver injury (n = 3; 23.1%) and isoniazid presented a hepatocellular pattern (n = 2; 15.4%). The CIOMS/RUCAMS allowed the identification of possible (n = 7; 53.9%), probable (n = 4; 30.8%) and highly-probable cases (n = 2; 15.4%) of DILI. Amoxicillin/clavulanate, isoniazid, isotretinoin, methotrexate and Herbalife nutritional products were implicated as highly-probable and probable agents. The highest percentage of DILI corresponded to mild cases that recovered after the discontinuation of the agent involved (n = 9; 69.3%). The consumption of Herbalife botanical products is associated with probable causality and fatality (n = 1; 7.7%). In conclusion, the frequency of DILI cases controlled by the Department of Gastroenterology of the Hospital Universitario of Maracaibo was low, being ibuprofen, acetaminophen, isoniazid and products Herbalife the products most commonly involved. It is recommended to continue with the prospective registration of cases, with an extended follow up monitoring period and to facilitate the incorporation of other hospitals in the Zulia State and Venezuela.
药物性肝损伤（DILI）是全球发病和死亡的一个重要原因，存在不同的地域差异。这项前瞻性、描述性横断面研究的目的是确定并描述委内瑞拉苏利亚州一家医院的DILI病例。对2012年12月至2013年12月期间委内瑞拉苏利亚州大学医院胃肠病科接诊的13例疑似DILI患者进行了研究。布洛芬（n = 3；23.1%）、对乙酰氨基酚（n = 3；23.1%）、异烟肼（n = 2；15.4%）和康宝莱产品（n = 2；15.4%）是导致DILI的主要药物。对乙酰氨基酚和布洛芬表现为混合型肝损伤（n = 3；23.1%），异烟肼表现为肝细胞型（n = 2；15.4%）。CIOMS/RUCAMS标准可识别可能的（n = 7；53.9%）、很可能的（n = 4；30.8%）和极有可能的（n = 2；15.4%）DILI病例。阿莫西林/克拉维酸、异烟肼、异维A酸、甲氨蝶呤和康宝莱营养产品被认为是极有可能和很可能的致病因素。DILI中最高比例的是轻度病例，在停用相关药物后康复（n = 9；69.3%）。食用康宝莱植物产品与可能的因果关系和死亡有关（n = 1；7.7%）。总之，马拉开波大学医院胃肠病科控制的DILI病例发生率较低，布洛芬、对乙酰氨基酚、异烟肼和康宝莱产品是最常涉及的产品。建议继续对病例进行前瞻性登记，延长随访监测期，并促进苏利亚州和委内瑞拉其他医院的纳入。
