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Previous Volume 333:1118-1127 October 26, 1995 Number 17 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Drug-induced liver injury is a potential complication of nearly every medication that is prescribed, because the liver is central to the metabolic disposition of virtually all drugs and foreign substances.^1,2,3 Although drugs are usually metabolized without injury to the liver, many fatal and near-fatal drug reactions occur each year. A few compounds produce metabolites that cause liver injury in a uniform, dose-dependent fashion.^4,5,6 Most agents form a toxic byproduct only in rare persons. Injury to hepatocytes results either directly from the disruption of intracellular function or membrane integrity or indirectly from immune-mediated membrane damage. Factors promoting the accumulation of hepatocyte . . . [Full Text of this Article]

Background

Phase 1 Reactions

Phase 2 Reactions

Glutathione Metabolism

Pathogenesis of Toxic Reactions

Enzyme Polymorphism

Hepatocyte Necrosis

Role of Physiologic Factors

Types of Drug Reactions

Direct Toxic Reactions (Acetaminophen)

Idiosyncratic Reactions (Isoniazid)

Combined Toxic and Allergic Reactions (Halothane)

Allergic Hepatitis (Phenytoin)

Cholestatic Reactions (Estradiol)

Granulomatous Reactions

Drug-Induced Chronic Hepatitis (Methyldopa)

Fatty Liver and Alcoholic Hepatitis–Like Reactions (Amiodarone)

Indolent Cirrhosis (Methotrexate)

Veno-Occlusive Disease

Other Factors in Drug-Induced Liver Disease

Cocaine Abuse

Nonprescription and Reformulated Agents

Multidrug Regimens

Diagnosis, Treatment, and Prevention

Source Information

From the Liver Unit, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-8887, where reprint requests should be addressed to Dr. Lee.

References

Related Letters:

Drug-Induced Hepatotoxicity
De Roos F. J., Hoffman R. S., Palleschi G. T., Noble A., MacDonald A., Morales J. M., Fenichel R. R., Lee W. M.
Extract | Full Text  
N Engl J Med 1996; 334:863-864, Mar 28, 1996. Correspondence

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