Hepatotoxicity overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Overview

Hepatotoxicity implies chemical-driven liver damage. The liver plays a central role in transforming and clearing chemicals and is susceptible to the toxicity from these agents. Certain medicinal agents when taken in overdoses and sometime even when introduced within therapeutic ranges may injure the organ. Other chemical agents such as those used in laboratories and industries, natural chemicals (e.g. microcystins) and herbal remedies can also induce hepatotoxicity. Chemicals that cause liver injury are called hepatotoxins.

Historical Perspective

Classification

Pathophysiology

Causes

More than 900 drugs have been implicated in causing liver injury^[1] and it is the most common reason for a drug to be withdrawn from the market. Chemicals often cause subclinical injury to liver which manifests only as abnormal liver enzyme tests. Drug induced liver injury is responsible for 5% of all hospital admissions and 50% of all acute liver failures.^[2]^[3]

Differentiating Hepatotoxicity from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

References

↑ Friedman, Scott E.; Grendell, James H.; McQuaid, Kenneth R. (2003). Current diagnosis & treatment in gastroenterology. New York: Lang Medical Books/McGraw-Hill. pp. p664–679. ISBN 0-8385-1551-7.
↑ McNally, Peter F. GI/Liver Secrets: with STUDENT CONSULT Access. Saint Louis: C.V. Mosby. ISBN 1-56053-618-7.
↑ Ostapowicz G, Fontana RJ, Schiødt FV; et al. (2002). “Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States”. Ann. Intern. Med. 137 (12): 947–54. PMID 12484709.

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[isbn0-8385-1551-7-1] Friedman, Scott E.; Grendell, James H.; McQuaid, Kenneth R. (2003). Current diagnosis & treatment in gastroenterology. New York: Lang Medical Books/McGraw-Hill. pp. p664–679. ISBN 0-8385-1551-7.

[isbn1-56053-618-7-2] McNally, Peter F. GI/Liver Secrets: with STUDENT CONSULT Access. Saint Louis: C.V. Mosby. ISBN 1-56053-618-7.

[3] Ostapowicz G, Fontana RJ, Schiødt FV; et al. (2002). “Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States”. Ann. Intern. Med. 137 (12): 947–54. PMID 12484709.

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