Original ResearchFull Report: Clinical—LiverIncidence, Presentation, and Outcomes in Patients With Drug-Induced Liver Injury in the General Population of Iceland
Section snippets
Materials and Methods
Iceland has a population of approximately 251,000 inhabitants older than age 15. All physicians in the country received a letter concerning this upcoming prospective study in January and February of 2010, stating the purpose of the study. In the letter the physicians were encouraged to report to the investigators, via e-mail, all suspected patients older than the age of 15, with liver injury suspected to be caused by drugs or herbal medicines and/or dietary supplements (HDS), with predefined
Results
During the 2-year study period a total of 96 patients, including 54 (56%) women, median age of 55 (interquartile range [IQR], 38–69 y), were identified who fulfilled the criteria for inclusion in the study. The youngest patient was 16 years old and the oldest patient was 91 years old. Overall, 110 patients originally were recorded in the study but 14 patients had to be excluded: 7 of these had nondrug causes for their liver injury, owing to polymyalgia rheumatica, Epstein–Barr hepatitis,
Incidence of DILI
The crude incidence observed in the present study, 19.1 per 100, 000 inhabitants per year, is similar although somewhat higher than in the only other published population-based study from France that showed a crude incidence of 13.9 cases per 100,000.4 There are some differences between these 2 studies that have to be taken into account. In the current study, liver injury resulting from acetaminophen was excluded whereas this was not the case in the French study.4 In fact, 1 of the 2 patients
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This article has an accompanying continuing medical education activity on page e19. Learning Objective: Upon completion of this CME exercise, successful learners will be able to summarize the incidence of drug-induced liver injury (DILI), the most common type of drugs associated with DILI and the highest risk of drugs associated with DILI as well as the prognosis of patients with jaundice owing to DILI.
Conflicts of interest The authors disclose no conflicts.
Funding Supported by a grant from the National University Hospital of Iceland Research Fund.