Title |
A Multicenter Study Into Causes of Severe Acute Liver Injury
|
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Published in |
Clinical Gastroenterology and Hepatology, August 2018
|
DOI | 10.1016/j.cgh.2018.08.016 |
Pubmed ID | |
Authors |
Anthony C Breu, Vilas R Patwardhan, Jennifer Nayor, Jalpan N Ringwala, Zachary G Devore, Rahul B Ganatra, Kelly E Hathorn, Laura Horton, Sentia Iriana, Elliot B Tapper |
Abstract |
The differential diagnosis of an increase in alanine aminotransferase (ALT) level and/or aspartate aminotransferase (AST) level of ≥1000 IU/L often is stated to include 3 main etiologies: ischemic hepatitis, acute viral hepatitis (typically hepatitis A and hepatitis B), and drug-induced (more specifically, acetaminophen/paracetamol) liver injury (DILI).1 Unfortunately, there are a paucity of studies examining the most common causes of acute liver injury (ALI) and those that have been published have been small,2 single-center,2 or examined less severe increases in ALT or AST levels.3,4 We conducted a multicenter study of all patients with an ALT and/or AST level ≥1000 IU/L. Our study had 3 main goals: (1) to determine the most common causes of an ALT and/or AST level ≥1000 IU/L, along with their relative frequencies; (2) to determine differences in etiology based on hospital type (liver transplant center, community hospital, Veterans Affairs hospital); and (3) to confirm or disprove the differential heuristic that ischemic hepatitis, acute viral hepatitis, and acetaminophen toxicity are the most common etiologies. |
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Malaysia | 9 | 2% |
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Saudi Arabia | 9 | 2% |
Philippines | 5 | 1% |
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Practitioners (doctors, other healthcare professionals) | 84 | 19% |
Scientists | 35 | 8% |
Science communicators (journalists, bloggers, editors) | 5 | 1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 35 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Other | 4 | 11% |
Student > Bachelor | 4 | 11% |
Student > Master | 4 | 11% |
Student > Postgraduate | 3 | 9% |
Other | 3 | 9% |
Unknown | 12 | 34% |
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Nursing and Health Professions | 2 | 6% |
Unspecified | 1 | 3% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Other | 0 | 0% |
Unknown | 14 | 40% |