Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury

Luke Hillman, Michelle Gottfried, Maureen Whitsett, Jorge Rakela, Michael Schilsky, William M. Lee, Daniel Ganger

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

OBJECTIVES: The increasing use of complementary and alternative medicines (CAMs) has been associated with a rising incidence of CAM-induced drug-induced liver injury (Dili). The aim of this study was to examine the clinical features and outcomes among patients with acute liver failure (ALF) and acute liver injury (ALI) enrolled in the Acute Liver Failure Study Group database, comparing CAM-induced with prescription medicine (PM)-induced Dili. METHODS: A total of 2,626 hospitalized patients with ALF/ALI of any etiology were prospectively enrolled between 1998 and 2015 from 32 academic transplant centers. Only those with CAM or PM-induced ALI/ALF were selected for analysis. RESULTS: A total of 253 (9.6%) subjects were found to have idiosyncratic Dili, of which 41 (16.3%) were from CAM and 210 (83.7%) were due to PM. The fraction of Dili-ALF/ALI cases due to CAM increased from 1998-2007 to 2007-2015 (12.4 vs. 21.1%, P=0.047). There was no difference in the type of liver injury - hepatocellular, cholestatic, or mixed - between groups as determined by R score (P=0.26). PM-induced Dili showed higher serum alkaline phosphatase levels compared with the CAM group (median IU/L, 171 vs. 125, P=0.003). The CAM population had fewer comorbid conditions (1.0 vs. 2.0, P

Original languageEnglish (US)
Pages (from-to)958-965
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume111
Issue number7
DOIs
StatePublished - Jul 1 2016

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint Dive into the research topics of 'Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury'. Together they form a unique fingerprint.

  • Cite this