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Journals / Dicle Tıp Dergisi / 2018 / Cilt: 45 - Sayı: 2

Toxic hepatitis experience of the tertiary gastroenterological clinics in the Southeastern Anatolia

Güneydoğu Anadolu Bölgesindeki Üçüncü Basamak Gastroenteroloji Kliniğinin Toksik Hepatit Deneyimi

FEYZULLAH UÇMAK
Elif Tuğba TUNCEL
Hüseyin KAÇMAZ
Berat EBİK
Muhsin KAYA
Pages
157–164
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The use of narcotics for young men in particular plays a large role in the etiology of toxic hepatitis.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Toxic hepatitis is a clinical picture caused by the intake of many drugs and herbal products.
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Key Findings & Data:Methods: This study comprises patients hospitalized at our clinics due to abnormal liver function tests and diagnosed with toxic hepatitis as a result of clinical and laboratory examinations between August 2014 and June 2016.
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Conclusion & Impact:The use of narcotics for young men in particular plays a large role in the etiology of toxic hepatitis.
🔬Design:Research Article
📍Scope:2014 Verileri
⚙️Variables:Domain Parameters

Abstract

Objective: Toxic hepatitis is a clinical picture caused by the intake of many drugs and herbal products. Numerous drugs lead to toxic hepatitis through a variety of mechanisms. The prevalence and causes of the disease vary by regions. This study aims at presenting demographic, clinical and laboratory characteristics of toxic hepatitis cases that sought medical care at our clinics. Methods: This study comprises patients hospitalized at our clinics due to abnormal liver function tests and diagnosed with toxic hepatitis as a result of clinical and laboratory examinations between August 2014 and June 2016. The demographic characteristics of the patients, the potential etiology of the toxic hepatitis, clinical characteristics, biochemical and complete blood count results and the clinical course were recorded. Results: Fifty-six patients (34 women) with a mean age of 41.4±16.8 were included in this study. Toxic hepatitis was detected in 31 patients (55.6%) for use of drugs, 11 patients (20.4%) of herbal products, 6 patients (9.3%) of narcotic substances and 8 patients (14.8%) of herbal substances, drugs and narcotics. The most common drugs of all were antibiotics (amoxicillin + clavulanic acid ranking atop) and non-steroidal anti-inflammatory drugs (diclofenac sodium ranking atop). Patients with the use of herbal products commonly had a history of use for milk thistle, lavender tea and atom tea. The most common narcotic substance turned out to be ecstasy (5 patients). The age under thirty (RR: 1.545, p<0.001) and the male gender (RR: 11.0, p=0.013) were determined as risk factors for the use of narcotics. Conclusion: Caused by the use of drugs and herbal products across the region, TH should be taken into consideration as a major cause of abnormal liver function tests. The use of narcotics for young men in particular plays a large role in the etiology of toxic hepatitis.

Özet

Amaç: Toksik hepatit birçok ilaç ve bitkisel ürünün alınmasıyla ortaya çıkan klinik tablodur. Çok sayıda ilaç değişik mekanizmalarla toksik hepatite neden olmaktadır. Hastalığın görülme sıklığı ve sebepleri bölgesel farklılıklar gösterebilmektedir. Çalışmadaki amacımız kliniğimize başvuran toksik hepatitli olguların demografik, klinik ve laboratuar özelliklerini sunmaktır. Yöntemler: Ağustos 2014-Haziran 2016 tarihleri arasında kliniğimize anormal karaciğer fonksiyon testleri nedeniyle yatırılan, klinik ve laboratuar değerlendirme sonrası TH tanısı konulan hastalar alındı. Hastaların demografik özellikleri, toksik hepatitin muhtemel etiyolojisi, klinik özellikleri, biyokimya ve tam kan değerleri, klinik seyirleri kaydedildi. Bulgular: Çalışmaya yaş ortalaması 41.4±16.8 olan 56 (34 kadın) hasta alındı. Hastaların 31 (%55.6)’inde ilaçlar, 11 (%20.4)’inde bitkisel maddeler, 6 (%9,3)’ında narkotik madde ve 8 (%14,8)’inde bitkisel madde, ilaç ve narkotik kullanımına bağlı toksik hepatit geliştiği saptandı. İlaçlar içinde en çok antibiyotik (birinci sırada amoksisilin+ klavulanik asit) ve non-steroid anti inflamatuvar ilaç (birinci sırada diklofenak sodyum) kullanımı hikayesi saptandı. Bitkisel madde kullanımı olan hastalarda en sık meryem otu, lavanta çayı ve atom çayı kullanım hikayesi mevcuttu. Narkotik madde olarak en sık ekstazi (5 hasta) kullanımı saptandı. Otuz yaş altı (RR:1.545, p<0.001) ve erkek cinsiyet (RR:11.0, p=0.013) narkotik madde kullanımı için risk faktörü olarak saptandı. Sonuç: Bölgemizde ilaç ve bitkisel madde kullanımına bağlı gelişen TH anormal karaciğer fonksiyon testlerinin önemli bir sebebi olarak dikkate alınmalıdır. Özellikle genç erkeklerde narkotik kullanımı toksik hepatit etiyolojisinde önemli yer tutmaktadır.

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Cite This Article

UÇMAK, F., TUNCEL, E. T., KAÇMAZ, H., EBİK, B., KAYA, M. (2018). Toxic hepatitis experience of the tertiary gastroenterological clinics in the Southeastern Anatolia. Dicle Tıp Dergisi, Cilt: 45 - Sayı: 2, 157–164. https://ajindex.com/articles/196115

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References (10)

  1. Friis H, Andreasen PB. 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; 232: 133–8. Ibáñez L, Pérez E, Vidal X, Laporte JR, the Grup d’Estudi Multi- centric d’Hepatotoxicitat Aguda de Barcelona (GEMHAB). Pro- spective surveillance of acute serious liver disease unre-lated to infectious, obstructive, or metabolic diseases: epidemiological and clinical features, and exposure to drugs. J Hepatol 2002; 37:592–600
  2. Sgro C, Clinard F, Ouazir K, et al. Incidence of drug-induced hepatic injuries: a French population-based study. Hepatology 2002; 36: 451–5.
  3. Andrade RJ, Lucena MI. Drug-induced hepatotoxicity. N Engl J Med 2003; 349:1974–6. National Institutes of Health (NIH) and LiverTox: Agents Included in LiverTox by Drug Class. Available online: https://livertox.nlm.nih.gov//Herbals_and_Dietary_Supplements.htm (accessed on 17 Octoberber 2017).
  4. Strader DB, Seeff LB. Hepatotoxicity of herbal preparation. Chapter 37. In: Boyer TD, Wright TL, Manns MP, eds. Zakim and Boyer’s hepatology, a textbook of liver disease. 5th ed. Philadelphia, PA:Saunders-Elsevier, 2006: 551–60. Seeff LB. Herbal hepatotoxicity. Clin Liver Dis 2007; 11:577–96.
  5. Atayan Y, Çağın YF, Erdoğan MA, Harputluoglu MM, Bilgic Y. Ecstasy induced acute hepatic failure. Case reports. Acta Gastroenterol Belg. 2015 Jan-Mar; 78:53-5.
  6. Guneysel O, Onur OE, Akoglu H, Denizbasi A. Ecstasy-induced recurrent toxic hepatitis in a young adult. Curr Ther Res Clin Exp. 2008 Jun; 69:260-5. doi: 10.1016/j.curtheres.2008.06.001 Arria AM, Yacoubian GS Jr, Fost E, Wish ED. The pediatric forum: Ecstasy use among club rave attendees. Arch Pediatr Adolesc Med. 2002; 156: 295-6.
  7. Wu D, Otton SV, Inaba T, et al. Interactions of amphetamine analogs with human liver CYP2D6. BiochemPharmacol.1997; 53:1605-12. Christophersen AS. Amphetamine designer drugs--an overviewand epidemiology. Toxicol-Lett. 2000;112-113:127-131
  8. Ganey PE, Luyendyk JP, Maddox JF, et al. Adverse hepatic drug reactions: inflammatory episodes as consequence and contributor. Chem Biol Interact 2004; 150:35–51 Pillans PI. Drug associated hepatic reactions in New Zealand: 21 years experience. N Z Med J 1996; 109:315–9.
  9. De Valle MB, Klinteberg VA, Alem N, et al. Drug induced liver injury in a Swedish Uni-versity Hospital out-patient hepatology clinic. Aliment Pharmacol Ther 2006;24:1187–95.
  10. Andrade RJ, Lucena MI, Fernandez MC, et al. Drug induced liver injury: an