Document Detail


Detective work in drug-induced liver injury: sometimes it is all about interviewing the right witness.
MedLine Citation:
PMID:  20363371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diagnosing drug-induced liver injury (DILI) relies primarily on history taking. We report 4 cases in which DILI was missed or the drug was misidentified when physicians relied solely on patient history. We reviewed 27 cases referred with possible DILI from August 1, 2009, to February 1, 2010. Four patients seemed to be reliable historians, but their cases were greatly clarified by a call to their pharmacist. One subject, who forgot a new medication, underwent an unfruitful evaluation including surgery. Another patient had acetaminophen toxicity that was missed because she grossly underreported her pain medication use. The third and fourth patients forgot taking amoxicillin/clavulanate, so other agents mistakenly were implicated. Roussel Uclaf Causality Assessment Method scores were 8 (probable) or 9 (highly probable) for all 4 cases. Without pharmacy input, DILI was missed in 2 cases and the wrong agent was implicated twice. Reviewing pharmacy records can be crucial for patients and DILI research. We recommend calling the pharmacist directly for increased liver enzyme levels of unclear source or suspected DILI regardless of patient history.
Authors:
A Sidney Barritt; Joseph Lee; Paul H Hayashi
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-04-02
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  8     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-06     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  635-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Drug-Induced Liver Injury / diagnosis*,  etiology*
Female
Humans
Information Storage and Retrieval / methods
Male
Medical History Taking / methods*
Middle Aged
Pharmacists
Grant Support
ID/Acronym/Agency:
P30 DK034987/DK/NIDDK NIH HHS; T32 DK007634/DK/NIDDK NIH HHS; T32 DK007634-09/DK/NIDDK NIH HHS; T32 DK07634/DK/NIDDK NIH HHS; U01 DK065201/DK/NIDDK NIH HHS
Comments/Corrections

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