Drug-Induced Acute Liver Failure

The Acute Liver Failure Study Group is a consortium of investigators at multiple sites across the U.S. In this report, representing 23 academic centers, the group describes its experience with drug-induced acute liver failure from 1998 through 2007. Of 1198 cases of acute liver failure encountered by the consortium, 133 (11%) were considered to be drug-induced; acetaminophen overdose cases were excluded.

Seventy percent of patients were women. Enzyme abnormalities usually conformed to a hepatocellular pattern, but a cholestatic pattern was noted in 13%. Median duration of drug exposure before hospital admission was 2 months. The most commonly implicated drugs were isoniazid alone or in combination with other antituberculous drugs (25 cases),…