| Clinical and Histopathologic Features of Fluoroquinolone-Induced Liver Injury. | |
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MedLine Citation:
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PMID: 21356330 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: Fluoroquinolone-induced liver injury is rare; no prospective studies of well-characterized case series have been published. We studied patients with fluoroquinolone-induced hepatoxicity, using data from the Drug-Induced Liver Injury Network (DILIN) to characterize injury patterns, outcomes, and associated features. METHODS: We identified subjects with fluoroquinolone hepatotoxicity who enrolled in the DILIN from September 2004 to January 2010. Demographic, clinical, and laboratory data were analyzed by descriptive statistical methods. RESULTS: Of the 679 registrants in the DILIN prospective study, 12 had hepatoxicity from fluoroquinolones (6 ciprofloxacin, 4 moxifloxacin, 1 levofloxacin, and 1 gatifloxacin). Seven were women; the median age was 57 years (range 23-80 years), and the median time from the start of fluoroquinolone therapy to symptoms was only 4 days (range 1-39 days). Nine cases developed symptoms on medication (2, 8, and 32 days after they stopped the medication, 3 patients each). Cases were equally distributed among hepatocellular injury (predominantly increased levels of alanine aminotransferase), cholestatic injury (predominantly increased levels of alkaline phosphatase [AP]), and both. Seven cases had immunoallergic features. Patients with mixed hepatocellular and cholestatic injury had mild disease without jaundice-all recovered. In contrast, 2 of 4 patients with hepatocellular injury and jaundice died, 1 of acute liver failure. One patient with cholestatic injury developed vanishing bile duct syndrome and required liver transplantation; another had a persistently increased serum level of AP. CONCLUSIONS: Fluoroquinolone liver injury is rapid in onset and often has immunoallergic features, indicating a hypersensitivity reaction. The pattern of injury is can be hepatocellular, cholestatic, or mixed-mixed cases are the least severe. Acute and chronic liver failure can occur. |
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Authors:
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Eric S Orman; Hari S Conjeevaram; Raj Vuppalanchi; James W Freston; James Rochon; David E Kleiner; Paul H Hayashi; |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-25 |
Journal Detail:
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Title: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Volume: - ISSN: 1542-7714 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-3-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101160775 Medline TA: Clin Gastroenterol Hepatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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