급성 독성간염 159예의 임상적 고찰
Clinical characteristics of 159 cases of acute toxic hepatitis
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Backgrounds/Aims: Toxic hepatitis has recently been discovered to be a major cause of acute hepatitis. We studied the clinical features and prognosis of patients diagnosed with toxic hepatitis at a single institution. Methods: A retrospective analysis was performed using medical records of 159 cases of toxic hepatitis that were diagnosed from March 2003 to March 2008. Patients were selected based on a RUCAM score of 4 or above. Results: The incidence was higher in women (n=97) than in men (n=62). The age (mean±SD) of the patients was 51±15 years . The major causes of the disease included the use of Korean traditional therapeutic preparations (34.0%), herbal medicines (41.5%), and drugs prescribed by a physician (23.9%). At the time of admission, jaundice was the most common symptom (41.5%), and the results of a liver serum battery were as follows: aspartate aminotransferase, 729.4±877.0 IU/L; alanine aminotransferase, 857.1±683.0 IU/L; total bilirubin, 6.4±6.5 mg/dL; and alkaline phosphatase, 209.8±130.0 IU/L. The hospitalization period was 10.0±9.5 days, and the duration of recovery from liver injury was 31.0±29.5 days. The factors associated with the hospitalization period included the presence of anorexia and the serum levels of albumin and bilirubin at the time of admission (P<0.05). A high serum bilirubin level and a history of alcohol ingestion were associated with a delayed recovery (P<0.05). The sex, age, BMI, and duration of medication were not significantly related to the hospitalization and recovery periods. Conclusions: The main cause of acute toxic hepatitis in the current study was the use of herbal medicines. The severity of liver injury at the time of admission was a major factor significantly associated with the hospitalization and recovery periods.
Abstract
Backgrounds/Aims: Toxic hepatitis has recently been discovered to be a major cause of acute hepatitis. We studied the clinical features and prognosis of patients diagnosed with toxic hepatitis at a single institution. Methods: A retrospective analysis was performed using medical records of 159 cases of toxic hepatitis that were diagnosed from March 2003 to March 2008. Patients were selected based on a RUCAM score of 4 or above. Results: The incidence was higher in women (n=97) than in men (n=62). The age (mean±SD) of the patients was 51±15 years . The major causes of the disease included the use of Korean traditional therapeutic preparations (34.0%), herbal medicines (41.5%), and drugs prescribed by a physician (23.9%). At the time of admission, jaundice was the most common symptom (41.5%), and the results of a liver serum battery were as follows: aspartate aminotransferase, 729.4±877.0 IU/L; alanine aminotransferase, 857.1±683.0 IU/L; total bilirubin, 6.4±6.5 mg/dL; and alkaline phosphatase, 209.8±130.0 IU/L. The hospitalization period was 10.0±9.5 days, and the duration of recovery from liver injury was 31.0±29.5 days. The factors associated with the hospitalization period included the presence of anorexia and the serum levels of albumin and bilirubin at the time of admission (P<0.05). A high serum bilirubin level and a history of alcohol ingestion were associated with a delayed recovery (P<0.05). The sex, age, BMI, and duration of medication were not significantly related to the hospitalization and recovery periods. Conclusions: The main cause of acute toxic hepatitis in the current study was the use of herbal medicines. The severity of liver injury at the time of admission was a major factor significantly associated with the hospitalization and recovery periods.
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