| [ Summary ] |
A nationwide survey revealed that complications such as metabolic syndrome and malignancies were underling factors for most patients with fulminant hepatitis and LOHF in Japan. These patients had received daily medications. The frequencies of administration were 42 % and 53 %, respectively, in acute and subacute types of fulminant hepatitis and 57% for LOHF. However, the number of patients for whom the etiology of liver failure was determined to be drugs-induced liver injury, determined through clinical courses and by D-LST, was lower. The ratios of patients were 8 % of the acute type, 13 % of the subacute type and 18 % of the LOHF. Health foods, such as supplements, were frequently found to be causative agents inducing liver injuries from 2003 on. The survival rates for patients receiving therapies other than liver transplantation were 61 % and 27 %, respectively for acute and subacute types of fulminant hepatitis and 0 % for LOHF. These ratios were almost identical to those observed in patients with indeterminate etiology. A large number of patients with indeterminate etiology were classified into clusters similar to those with drug-induced liver injury. In accordance with clustering analysis performed with an artificial neural network, drug-induced liver injury may prevail as the etiology of liver failure even in patients for whom an etiology is not identified. |