Abstract

FERNANDEZ-CASTANER, A. et al. An Analysis of the causes, characteristics, and consequences of reexposure to a drug or compound responsible for a hepatotoxicity event. Rev. esp. enferm. dig. [online]. 2008, vol.100, n.5, pp.278-284. ISSN 1130-0108.

Introduction: reexposure to a causal agent represents a potentially serious event in hepatotoxicity. Objectives: to assess the characteristics and outcome of cases with positive reexposure. Material and methods: a retrospective study of cases with evidence of positive reexposure included in Registro Español de Hepatopatías Asociadas a Medicamentos, and an analysis of their relation to demographic and clinical variables, causality, course, and consequences. Results: of a total of 520 cases 31 (6%) met reexposure criteria. Fatal outcomes, needs for admission, and mean recovery time were all higher for hepatocellular-type toxic injury. The most commonly identified drug class was antibiotics. On most occasions (73%) reexposure to the causal compound escaped notice because of: absence of index case diagnosis, lack of information to patients and their physicians, and (12%) development of cross reactions between structurally similar drugs. Conclusions: accidental reexposure to a drug or a structurally-related compound after an initial hepatotoxicity event is common and may have serious consequences, particularly in hepatocellular-type toxicity. Careful history taking and reflecting diagnostic suspicion in the initial episode’s record may reduce the incidence of this iatrogenic event.

Keywords : Reexposure; Hepatotoxicity; Drug-induced liver disease; Hepatic adverse events.

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