巴西药物性肝损伤作为急性肝衰竭病因的评估。
Evaluation of drug-induced liver injury as etiology for acute liver failure in Brazil.
作者信息
Santos Genario, Figueira Estela Regina Ramos, D'Albuquerque Luiz Augusto Carneiro, Lisboa Paulo Bittencourt, de Almeida Marcio Dias, Filgueira Norma Arteiro, Boin Ilka, Porta Gilda, da Silva Rita de Cássia Martins Alves, Viana Cyntia Ferreira Gomes, Faria Luciana Costa, Alvares-da-Silva Mario Reis, de Moraes Adriano Claudio Pereira, Morsoletto Daphne Benatti Goncalves, Codes Liana, Paraná Raymundo
机构信息
Health Science Postgraduation, Faculty of Medicine, University Federal of Bahia, Brazil.
Department of Gastroenterology, Division of Digestive Surgery, Hospital das Clinicas of University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
出版信息
Ann Hepatol. 2021 Jul-Aug;23:100310. doi: 10.1016/j.aohep.2021.100310. Epub 2021 Jan 27.
INTRODUCTION AND OBJECTIVES
Little is known about the etiology of acute liver failure (ALF) in Latin America. The objective of this paper is to investigate the main etiologies of ALF in Brazil, including Drug Induced Liver Injury (DILI) using stringent causality criteria.
PATIENTS OR MATERIAL AND METHODS
All the cases of individuals who underwent liver transplantation (LT) in 12 centers in Brazil for ALF were reviewed. When DILI was stated as the cause of ALF, causality criteria were applied on site by the main investigator in order to rule out other etiologies.
RESULTS
325 individuals had ALF mainly for unknown reasons (34%), DILI (27%) and AIH (18%). Reassessment of the 89 cases of DILI, using stringent causality criteria, revealed that in only 42 subjects could DILI be confirmed as the cause of ALF. Acetaminophen (APAP) toxicity (n = 3) or DILI due to herbal and dietary supplements (HDS) (n = 2) were not commonly observed.
CONCLUSIONS
Undetermined etiology and DILI are the main causes of ALF in Brazil. However, APAP toxicity and DILI due to HDS are mostly uncommon.
引言与目的
在拉丁美洲，人们对急性肝衰竭（ALF）的病因了解甚少。本文旨在调查巴西ALF的主要病因，包括使用严格因果关系标准的药物性肝损伤（DILI）。
患者或材料与方法
回顾了巴西12个中心因ALF接受肝移植（LT）的所有病例。当将DILI列为ALF的病因时，主要研究者在现场应用因果关系标准以排除其他病因。
结果
325例患者发生ALF，主要原因不明（34%）、DILI（27%）和自身免疫性肝炎（AIH，18%）。使用严格因果关系标准对89例DILI病例进行重新评估后发现，只有42例患者的ALF病因可确认为DILI。对乙酰氨基酚（APAP）毒性（n = 3）或草药和膳食补充剂（HDS）导致的DILI（n = 2）并不常见。
结论
病因不明和DILI是巴西ALF的主要原因。然而，APAP毒性和HDS导致的DILI大多不常见。
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