Drug-Induced liver Injury Associated with Severe Cutaneous Hypersensitivity Reactions: A Complex Entity in Need of a Multidisciplinary Approach
| Autor: | Raúl J. Andrade, Marina Almarza-Torres, Judith Sanabria-Cabrera, Inmaculada Medina-Caliz, M. Isabel Lucena, Simona Stankevičiūtė, Antonio Rodríguez-Nicolás |
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| Rok vydání: | 2019 |
| Předmět: |
Drug
medicine.medical_specialty media_common.quotation_subject Scars Context (language use) Dermatitis Atopic Drug Hypersensitivity 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Drug Discovery medicine Cutaneous hypersensitivity Genetic predisposition Humans Genetic Predisposition to Disease Adverse effect 030304 developmental biology media_common Pharmacology Liver injury 0303 health sciences business.industry medicine.disease Dermatology Toxic epidermal necrolysis Stevens-Johnson Syndrome Drug Hypersensitivity Syndrome medicine.symptom Chemical and Drug Induced Liver Injury business |
| Zdroj: | Current pharmaceutical design. 25(36) |
| ISSN: | 1873-4286 |
| Popis: | Idiosyncratic drug-induced liver injury (DILI) occasionally occurs in the setting of severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). This strengthens the proposed immunologic mechanism associated with this adverse reaction. DRESS exhibits the most common association with DILI. SCARs have a wide spectrum of heterogeneous clinical presentations and severity, and genetic predisposition has been identified. In the context of SCARs, DILI present a different clinical picture, ranging from mild injury to acute liver failure. Elucidating the role of DILI in the clinical presentation and outcome of SCARs represents a challenge due to limited information from published studies and the lack of consensus on definitions. The cholestatic and mixed pattern of liver damage typically predominates in the case of DILI associated with SCARs, which is different from DILI without SCARs where hepatocellular is the most common injury pattern. Only a few drugs have been associated with both DILI and SCARs. Is this article, the criteria used for DILI recognition among SCARS have been revised and discussed, along with the drugs most commonly involved in these syndromes as well as the outcome, prognostic factors and the need for a multidisciplinary approach to improve the management of DILI in the context of SCARs. |
| Databáze: | OpenAIRE |
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