Drug-induced hepatic injury is one of the most important problems in medical practice in recent years in Japan.
We collected 3330 cases of drug-induced hepatic injury reported in Japanese articles published over a period of 50 years from 1925 to 1974.
The numbers of cases in each decade were as follows: the first decade (1925-1934): 85 cases, the second decade (1935-1944): 177 cases the third decade (1945-1954): 88 cases, the fourth decade (1955-1964): 361 cases, the fifth decade (1965-1974): 2619 cases. Seventy-eight point sixty-five percent of total cases were reported in last ten years.
The greatest number of cases of drug-induced hepatic injury was due to chemotherapeutic drugs 840; drugs acting on the central nervous system 667; antibiotics 508, cardiovascular drugs 421; hormone and hormone antagonists 301; diagnostic aids 267; and other drugs; 326.
Ten of the most common drugs which caused hepatic injury were arsphenamine sodium, thorium dioxide, 4, 4'-diethylaminoethoxy hexestrol, ethionamide, chlorpromazine, erythromycin estolate, sulfonamide, PAS, rifampicin, ajmaline in descending order of frequency.
Most of the cases were diagnosed on the basis of clinical history, however, in some cases, readministration test, skin test, macrophage migration inhibitory test and lymphocyte transformation test of suspected drug was also performed as diagnostic aid.
The most common drugs reported to have high mortality due to severe hepatic impairment were thorium dioxide, combination chemotherapeutics for tuberculosis pyrazinamide, oxyphenisatin, halothane in descending order.
Eight-hundred and seventy-seven cases of drugs or poison ingestion for suicidal purposes, accidental inhalation of industrial or agricultural chemicals and food poisoning were also collected.
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