P-95 HEPATOXICITY FOR DRUGS AND HERBAL PRODUCTS IN INPATIENTS FROM A UNIVERSITY HOSPITAL, BRAZIL

Introduction

Drug induce liver injury (DILI) and Herbal Induce Liver Injrury (HILI) are a frequent complaint in clinical practice. These are manifested with alterations at the liver profile, and most of the time these are underdiagnosed.

Aims

To study the prevalence and clinic presentation of DILI/ HILI in 5 clinical inpatient rooms at a University Hospital.

Methods

Prospective cohort study with patients admitted between July and October 2020, in 5 inpatient rooms of the University Hospital of Bahia. RUCAM causality score was used to determine DILI/HILI, tests were performed to rule out another etiologies and to confirm DILI

Results

Total sample of 400 patients hospitalized for various causes, DILI/HILI was diagnosed in 10 patients: 2.5% of all the sample. Etiology: 90 % allopathic drugs: Clopromazine, Cephalexin, Mesalazine, Etrolizumab, Azatriopine associated with Hydrochloroquine, Tretinoin with Variconazole, Phenytoin, and RIPE (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol). Natural products were 10 %: Peumus boldus. Clinical symptoms: 100 % had jaundice; 50 % nausea; 25 % choluria; 25 % fecal acholia; 25 % vomiting; 25 % pruritus; 25 % insomnia; 25 % asthenia; 25 % arthralgia and 25 % eosinophilia. The mean time to resolution of symptoms was 18.5 days; the mean ALT level was 262.6; AST was 216.8 and AF was 1287, without severe cases.

Conclusions

The prevalence of DILI/ HDS in the inpatients was 2.5%, considered high, demonstrating the importance of the active search of these cases for its diagnosis.