Drug-induced hepatic injury: an analysis of 1100 cases reported to the Danish Committee on Adverse Drug Reactions between 1978 and 1987

J Intern Med. 1992 Aug;232(2):133-8. doi: 10.1111/j.1365-2796.1992.tb00562.x.

Abstract

The Danish Committee on Adverse Drug Reactions received 1100 reports of suspected drug-induced hepatic injury during the decade 1978-1987. The causal relationship between drug and hepatic injury was classified as definite in 57 (5.2%) reports, probable in 989 (89.9%) reports, possible in 50 (4.5%) reports and unclassifiable in four (0.4%) reports. Hepatic injuries accounted for 5.9% of all adverse drug reactions reported, and 14.7% of the lethal adverse drug reactions. A total of 47.2% were classified as acute cytotoxic, 16.2% as acute cholestatic and 26.9% as abnormal hepatic function. In 52 (4.7%) cases the hepatic injury was lethal; only 14 (1.3%) cases were chronic. Halothane accounted for 25% of the cases. The incidence of halothane-induced hepatic injury is decreasing, and only one lethal case has been reported since 1981. Next to halothane, sulfasalazine was the drug most often suspected during the last 2 years of the decade. Based on consumption data, the incidence of hepatic injury due to sulindac was estimated to be 18-fold higher than that due to ibuprofen. Paracetamol was reported to induce acute cytotoxic as well as cholestatic reactions in non-alcoholic subjects taking therapeutic doses.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alkaline Phosphatase / blood
  • Chemical and Drug Induced Liver Injury*
  • Child
  • Child, Preschool
  • Clinical Enzyme Tests
  • Denmark / epidemiology
  • Female
  • Humans
  • Infant
  • Liver Diseases / diagnosis
  • Liver Diseases / epidemiology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Transaminases / blood

Substances

  • Transaminases
  • Alkaline Phosphatase