Materiały źródłowe

• #1 Toxic Hepatitis,Causes, Symptoms, Complications and Prevention .

  https://www.linkedin.com/pulse/toxic-hepatitiscauses-symptoms-complications-hayk-arakelyan?trk=pulse-article_more-articles_related-content-card

  Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] Toxic hepatitis occurs when your liver develops inflammation because of exposure to a toxic substance. Toxic hepatitis may also develop when you take too much of a prescription or over-the-counter medication. […] Toxic hepatitis can be caused by: Alcohol. Heavy drinking over many years can lead to alcoholic hepatitis inflammation in the liver due to alcohol, which can lead to liver failure. Over-the-counter pain relievers. Nonprescription pain relievers such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can damage your liver, especially if taken frequently or combined with alcohol. Prescription medications. Some medications linked to serious liver injury include the statin drugs used to treat high cholesterol, the combination drug amoxicillin-clavulanate (Augmentin), phenytoin (Dilantin, Phenytek), azathioprine (Azasan, Imuran), niacin (Niaspan), ketoconazole, certain antivirals and anabolic steroids. There are many others. Herbs and supplements. Some herbs considered dangerous to the liver include aloe vera, black cohosh, cascara, chaparral, comfrey, kava and ephedra. There are many others. Children can develop liver damage if they mistake vitamin supplements for candy and take large doses. Industrial chemicals. Chemicals you may be exposed to on the job can cause liver injury. Common chemicals that can cause liver damage include the dry cleaning solvent carbon tetrachloride, a substance called vinyl chloride (used to make plastics), the herbicide paraquat and a group of industrial chemicals called polychlorinated biphenyls.

• #1 Toxic Hepatitis | Liver Canada

  https://liver.ca/toxic-hepatitis/

  Toxic hepatitis is a liver disease resulting in inflammation of the liver due to exposure to toxic substances. […] Toxic hepatitis is a form of liver disease caused by exposure to toxic substances. It occurs when the liver becomes inflamed due to the exposure to alcohol, drugs, chemicals, or toxins in the environment. […] Toxic hepatitis causes 10-15% of all liver failure cases globally. […] Since the liver has the unique ability to regenerate, if exposure to toxic substances is done in early stages, toxic hepatitis can be resolved naturally. […] Toxic hepatitis is a liver disease that can be prevented by avoiding exposure to toxic chemicals. […] Diagnosis for toxic hepatitis involves a thorough examination of previous exposures and daily activities followed by diagnostic testing if necessary. […] Treatment for toxic hepatitis focuses on limiting exposure to toxic substances and managing symptoms.

• #1 Liver Toxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526106/

  Additionally, herbal supplements cause a variety of symptoms, but their usage remains under-reported. […] Drug-induced liver injury is the most common cause of acute liver failure (ALF) in the United States and Europe and accounts for 20% to 40% of all instances of fulminant hepatic failure. […] Multiple risk factors like old age, female gender, chronic alcoholism, and pregnancy have been described in the literature to cause an increased risk of drug-induced liver injury. […] Some HLA types (human leukocyte antigen) serotypes have been identified as risk factors for drug-induced liver injury. […] Drug-induced liver injury can be dose-dependent/intrinsic, and on most occasions, it is dose-independent/idiosyncratic. […] Most other drugs cause a dose-independent pattern of hepatotoxicity.

• #1 Toxic Hepatitis (Liver Toxicity): Symptoms, Causes & Treatments

  https://my.clevelandclinic.org/health/diseases/17915-toxic-hepatitis

  Toxic hepatitis, or liver toxicity, is liver swelling (inflammation) that results from contact with a harmful substance (toxin), whether you: […] Exposure to certain chemicals or medications can cause toxic hepatitis symptoms to develop. Symptoms may develop soon after exposure, or they may develop over weeks or months. […] Some causes of toxic hepatitis include: […] This type of toxic hepatitis results from medications or supplements. Certain medications or dietary supplements may cause this drug-induced liver injury, including: […] Drinking too much alcohol can cause alcohol-induced hepatitis. […] You may develop liver toxicity if you take too much acetaminophen (Tylenol), an over-the-counter pain reliever. […] Taking too much vitamin A (more than 40,000 IU daily) can cause vitamin A liver toxicity.

• #1

  https://www.painscale.com/article/what-is-toxic-hepatitis

  Toxic hepatitis is inflammation of the liver caused by exposure to certain substances, such as drugs, chemicals or alcohol. […] Toxic hepatitis is categorized into three types: alcohol-induced, chemical-induced and drug-induced. […] Alcohol-induced hepatitis is caused by long-term, excessive alcohol consumption. […] Chemical-induced hepatitis is caused by exposure to certain chemicals; it most commonly occurs from exposure to chemicals or solvents in workplace settings. […] Drug-induced hepatitis is caused by repeated or excessive use of certain drugs, including over-the-counter medications, prescription medications, or supplements. […] The liver is responsible for breaking down drugs, medications, and other chemicals that enter the bloodstream. This process can cause the liver to produce byproducts from these toxins, which causes inflammation.

• #1 Toxic hepatitis | PPT

  https://www.slideshare.net/slideshow/toxic-hepatitis-149284884/149284884

  Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. In individuals who are prone to alcohol-related liver injury – possibly due to genetics – heavy drinking can result in acute liver failure. Other people may develop progressive liver disease from regular, heavy use of alcohol. […] Liver injury may be produced by a large variety of chemical substances. The type and degree of injury produced is extremely varied, and may mimic the entire spectrum of hepatobiliary disorders. The central role played by the liver in the clearance and biotransformation of chemical susceptibility to drug-induced injury. […] Drugs can initiate progressive chronic liver disease and are the single leading cause of acute liver failure.

• #1 Toxic Hepatitis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/toxic-hepatitis

  The liver processes almost everything a person consumes, including chemicals, medications and alcohol. In some instances, these substances may cause serious injury to the liver, resulting in toxic hepatitis a condition that causes inflammation of the liver. […] Many medications have the potential to cause liver toxicity and carry a warning on their label to this effect. […] In rare instances, however, some patients have an idiosyncratic reaction to a drug, causing massive destruction of liver cells and rapidly developing liver failure. […] Despite their widespread availability, some herbs and nutritional supplements may cause toxic hepatitis. […] Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. […] The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation.

• #1 Toxic Hepatitis | UCSF Department of Surgery

  https://transplantsurgery.ucsf.edu/condition/toxic-hepatitis

  The liver processes almost everything a person consumes, including chemicals, medications and alcohol. In some instances, these substances may cause serious injury to the liver, resulting in toxic hepatitis – a condition that causes inflammation of the liver. […] Many medications have the potential to cause liver toxicity and carry a warning on their label to this effect. […] In rare instances, however, some patients have an idiosyncratic reaction to a drug, causing massive destruction of liver cells and rapidly developing liver failure. […] Despite their widespread availability, some herbs and nutritional supplements may cause toxic hepatitis. […] Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. […] The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement.

• #1 Alcoholic hepatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/symptoms-causes/syc-20351388

  Alcoholic hepatitis is swelling, called inflammation, of the liver caused by drinking alcohol. Drinking alcohol destroys liver cells. […] Alcoholic hepatitis is caused by damage to the liver from drinking alcohol. Just how alcohol damages the liver and why it does so only in some heavy drinkers isn’t clear. […] These factors are known to play a role in alcoholic hepatitis: The body’s way of breaking down alcohol makes highly toxic chemicals. These chemicals trigger swelling, called inflammation, that destroys liver cells. Over time, scars replace healthy liver tissue. This keeps the liver from working well. This scarring, called cirrhosis, can’t be fixed. It’s the final stage of alcoholic liver disease. […] Other factors that can be involved with alcoholic hepatitis include: Other types of liver disease. Alcoholic hepatitis can make chronic liver diseases worse. For instance, if you have hepatitis C and drink, even a little, you’re more likely to get liver scarring than if you don’t drink. Lack of nutrition. Many people who drink heavily don’t get enough nutrients because they eat poorly. And alcohol keeps the body from using nutrients as it should. Lack of nutrients can damage liver cells.

• #1 Liver Toxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526106/

  One of the most important causes of liver dysfunction is drug-induced liver injury (DILI) which can lead to a wide spectrum of symptoms ranging from mild non-specific symptoms like asymptomatic transaminitis, acute hepatitis, chronic hepatitis, cholestasis to liver failure. […] It can be caused by a multitude of prescription drugs, herbal and dietary supplements and commonly leads to withdrawal of the drug from the market. […] There are many classes of drugs causing drug-induced liver injury including nonsteroidal anti-inflammatory drugs (NSAIDs), anti-infective drugs (anti-tubercular drugs), anti-cancer drugs, hormonal drugs, immunosuppressive agents, sedative, and neuropsychiatric drugs. […] The most common drug implicated in drug-induced liver injury is acetaminophen. […] Antibiotics are the class of drugs most commonly causing liver toxicity, and amoxicillin-clavulanate stands out as the most common drug in this class.

• #1 Hepatotoxicity – Wikipedia

  https://en.wikipedia.org/wiki/Hepatotoxicity

  Hepatotoxicity implies chemical-driven liver damage. Drug-induced liver injury (DILI) is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval. […] Chemicals that cause liver injury are called hepatotoxins. More than 900 drugs have been implicated in causing liver injury and it is the most common reason for a drug to be withdrawn from the market. Hepatotoxicity and drug-induced liver injury also account for a substantial number of compound failures, highlighting the need for toxicity prediction models, and drug screening assays, such as stem cell-derived hepatocyte-like cells, that are capable of detecting toxicity early in the drug development process. […] Adverse drug reactions are classified as type A (intrinsic or pharmacological) or type B (idiosyncratic). Type A drug reaction accounts for 80% of all toxicities.

• #1 Drug-induced liver injury: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000226.htm

  Drug-induced liver injury (DILI) is an injury of the liver that may occur when you take certain medicines. […] Many different drugs can cause drug-induced hepatitis. […] Painkillers and fever reducers that contain acetaminophen are a common cause of liver injury, particularly when taken in doses greater than those recommended. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac, and naproxen, may also cause drug-induced hepatitis. […] Other drugs that can lead to liver injury include: Amiodarone, Anabolic steroids, Birth control pills, Chlorpromazine, Erythromycin, Halothane (a type of anesthesia), Methyldopa, Isoniazid, Methotrexate, Statins, Sulfa drugs, Tetracyclines, Amoxicillin-clavulanate, Some anti-seizure medicines, Disulfiram, Niacin, Azathoaprine, Ketoconazole.

• #1 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  There are patient risk factors associated with the development of DILI, which include female sex, older age, and increased body mass index (BMI). More than 1000 medications and herbal compounds are known to cause hepatotoxicity and can be found on a searchable database maintained by the National Institute of Diabetes and Digestive, and Kidney Diseases (NIDDK) called LiverTox. Intrinsic DILI is most commonly caused by acetaminophen, while it is less often seen in aspirin, tetracycline, and vitamin A. […] Idiosyncratic DILI cases are caused by: Antibiotics (45.4%): amoxicillin-clavulanate (most common), sulfamethoxazole-trimethoprim, ciprofloxacin, isoniazid (INH); Nonsteroidal anti-inflammatory drugs (NSAIDs); Herbal and dietary supplements (16.1%): green tea extract, anabolic steroids, multi-ingredient nutritional supplements; Cardiovascular drugs (10%): statins, amiodarone; Central nervous system (CNS) agents: valproate, phenytoin; Antineoplastic drugs: tyrosine kinase inhibitors, tumor necrosis factor inhibitors, alpha inhibitors, methotrexate. […] More than 1000 medications and herbal compounds can cause drug-induced hepatotoxicity.

• #1 Alcoholic and Toxic Liver Disease | Nutrition Guide for Clinicians

  https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342081/all/Alcoholic_and_Toxic_Liver_Disease

  Hepatotoxicity from use of herbal and dietary supplements accounts for about 20% of all cases of drug-induced liver injury and may be the most common serious adverse effect of herbal supplements. Known hepatotoxic herbs causing liver injury include certain ayurvedic herbs, black cohosh, kava, pennyroyal oil, ma huang (Ephedra sinica), valerian, mistletoe, comfrey, chaparral, sassafras, borage, and germander. Herb-induced liver injury is a diagnosis of exclusion as the clinical presentation is not specific and may be attributed to a variety of other conditions. […] Acetaminophen toxicity is greatly increased with the concomitant ingestion of alcohol. […] High doses of preformed vitamin A can be hepatotoxic, as can certain botanicals. […] Some herbal supplements, particularly those from China and India, have been found to induce hepatoxicity as a result of improper extraction methods and contamination with heavy metals (mainly mercury, lead, arsenic, cadmium), among other causes.

• #1 Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb

  https://www.gutnliver.org/journal/view.html?volume=5&number=4&spage=493

  Complementary medicines, including herbal preparations and nutritional supplements, are widely used without prescriptions. As a result, there has been growing interest in the risk of hepatotoxicity with these agents. It is difficult to determine causal relationships between these herbal preparations and hepatotoxicity. We report on 25 patients diagnosed with toxic hepatitis following ingestion of Polygonum multiflorum Thunb. […] In our cases, we found that P. multiflorum Thunb could be hepatotoxic and could lead to severe drug-induced liver injury, and even death. […] DILI associated with herbal preparations is not uncommon in Western and Asian societies. […] The main constituents of Shou-Wu-Pain are polyphenols and anthraquinones – the latter is metabolized into anthrones and absorbed in the gastrointestinal tract, which can induce liver damage.

• #1 A Case of Toxic Hepatitis and Acute Liver Failure Induced by Ingestion of Raw Sansevieria

  https://www.anncaserep.com/full-text/accr-v2-id1429.php

  Herbal medicines are frequently used in the oriental region to treat a variety of disease and symptoms. Nearly 50% of patients with toxic hepatitis are related to these herbs and health supplements in Korea. […] This case is noteworthy because Sansevieria assumed to have hepatoprotective effect but is the first case reported for its fatal hepatotoxicity. […] In Korea, over 50% of patients with acute hepatitis are caused by drugs or toxins and 42-74.5% of the causes of toxic hepatitis were occupied by oriental medicines and other herbs. […] This case is the first to report the hepatotoxicity of raw Sansevieria, finally leading to death. […] With increasing interests in health and usage of herbal medicine, also the risks of developing DILI also is increasing. But there are few data regarding the incidence and clinical manifestation about DILI induced by herbal medicine. […] We are reporting for the first time with a case of Sansevieria induced toxic hepatitis, which was alleged to be hepatoprotective, to arouse that toxic hepatitis can occur by Sansevieria.

• #1 Toxic Hepatitis | Health & Human Services

  https://hhs.iowa.gov/epi-manual-guide-surveillance-investigation-and-reporting/environmental-disease/toxic-hepatitis

  Toxic hepatitis is any acute or sub-acute necrosis of the liver or other unspecified chemical hepatitis caused by exposure to non-medicinal toxic agents other than ethyl alcohol, including, but not limited to, carbon tetrachloride, chloroform, tetrachloroethane, trichloroethylene, phosphorus, TNT, chloronapthalenes, methylenedianilines, ethylene dibromide, and organic solvents. […] In an occupational setting, toxic hepatitis can occur when workers are exposed to industrial chemicals capable of causing liver damage. […] There are lists of chemicals known to cause illness or death due to acute hepatic injury after occupational exposure. […] Most statistics on toxic hepatitis combine the numbers for toxic hepatitis caused by drugs and toxic hepatitis caused by exposure to chemicals. […] The National Library of Medicine Haz-Map website lists 23 primary hepatotoxins and over 600 secondary hepatotoxins, increasing the risk of disease for workers in occupations or industries using these chemicals.

• #1 Hepatotoxicity – Wikipedia

  https://en.wikipedia.org/wiki/Hepatotoxicity

  Although individual analgesics rarely induce liver damage due to their widespread use, NSAIDs have emerged as a major group of drugs exhibiting hepatotoxicity. […] Isoniazide (INH) is one of the most commonly used drugs for tuberculosis; it is associated with mild elevation of liver enzymes in up to 20% of patients and severe hepatotoxicity in 1-2% of patients. […] There are also cases where other hydrazine derivative drugs, such as the MAOI antidepressant iproniazid, are associated with liver damage. […] Examples include alpha-Amanitin containing mushrooms, kava, and aflatoxin producing molds. Pyrrolizidine alkaloids, which occur in some plants, can be toxic. […] Examples include arsenic, carbon tetrachloride, and vinyl chloride.

• #1 Toxic hepatitis in occupational exposure to solvents

  https://www.wjgnet.com/1007-9327/full/v18/i22/2756.htm

  The solvents suspected to be responsible for liver occupational disease are: dimethylformamide (DMF), dimethylacetamide (DMA), trichloroethylene (TCE), tetrachloroethylene, carbon tetrachloride, xylene, toluene, and chloroform. […] It was found that 10% of workers exposed to TCE became jaundiced with massive hepatic necrosis. […] The data in humans, although limited, clearly suggests a toxic effect on human livers. Case reports describe TCE as inducing hepatitis and liver necrosis. […] Carbon tetrachloride is one of the most powerful solvents toxic to the liver, and is widely used in scientific research to assess liver damage and hepatoprotective agents. […] Indeed, carbon tetrachloride has been known for many years to be toxic to the liver. […] Hepatotoxicity has been observed in the literature in individuals exposed to xylene and toluene.

• #1 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Some drugs appear to have different toxicities based on race. […] Elderly persons are at increased risk of hepatic injury because of decreased clearance, drug-to-drug interactions, reduced hepatic blood flow, variation in drug binding, and lower hepatic volume. […] Alcoholic persons are susceptible to drug toxicity because alcohol induces liver injury and cirrhotic changes that alter drug metabolism. […] Preexisting liver disease has not been thought to make patients more susceptible to drug-induced liver injury, but it may be that a diminished liver reserve or the ability to recover could make the consequences of injury worse. […] The pathophysiologic mechanisms of hepatotoxicity are still being explored and include both hepatocellular and extracellular mechanisms. […] The classic division of drug reactions is into at least two major groups, (1) drugs that directly affect the liver and (2) drugs that mediate an immune response.

• #1 Hepatotoxicity – Wikipedia

  https://en.wikipedia.org/wiki/Hepatotoxicity

  Drugs or toxins that have a pharmacological (type A) hepatotoxicity are those that have predictable dose-response curves (higher concentrations cause more liver damage) and well characterized mechanisms of toxicity, such as directly damaging liver tissue or blocking a metabolic process. […] Idiosyncratic (type B) injury occurs without warning, when agents cause non-predictable hepatotoxicity in susceptible individuals, which is not related to dose and has a variable latency period. […] The herb kava has caused a number of cases of idiosyncratic liver injury, ranging everywhere from asymptomatic to fatal. […] Paracetamol overdose is the most common cause of drug-induced liver disease. Paracetamol is usually well-tolerated in prescribed dose, but overdose is the most common cause of drug-induced liver disease and acute liver failure worldwide.

• #1 Drug-Induced Liver Disease Types, Causes, Symptoms & Treatment

  https://www.medicinenet.com/drug_induced_liver_disease/article.htm

  The most important example of dose-dependent toxicity is acetaminophen (Tylenol) overdose. […] Idiosyncratic drug toxicity is difficult to detect in early clinical trials that usually involve, at most, only a few thousand patients. […] In drug allergy, the liver is injured by the inflammation that occurs when the body’s immune system attacks the drugs with antibodies and immune cells.

• #1 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  The spectrum of hepatic reactions ranges from mild transient elevations in transaminase levels to hepatitis, cholestasis, and fulminant hepatic failure. […] Hepatotoxicity from acetaminophen is due to the toxic metabolite NAPQI. […] Severe and fatal hepatitis has been reported with INH therapy. […] Microvesicular steatosis is observed with alcohol, aspirin, valproic acid, amiodarone, piroxicam, stavudine, didanosine, nevirapine, and high doses of tetracycline. […] The use of alternative medicines has led to many reports of toxicity. The spectrum of liver disease is wide with these medicines.

• #1 Toxic hepatitis

  https://ask-ahd.ahdubai.com/con-20166943

  Factors that may increase your risk of toxic hepatitis include: Taking over-the-counter pain relievers or certain prescription drugs. Taking a medication or over-the-counter pain reliever that carries a risk of liver damage increases your risk of toxic hepatitis. This is especially true if you take multiple medications or take more than the recommended dose of medication. Having a liver disease. Having a serious liver disorder such as cirrhosis or nonalcoholic fatty liver disease makes you much more susceptible to the effects of toxins. Having hepatitis. Chronic infection with a hepatitis virus (hepatitis B, hepatitis C or one of the other extremely rare hepatitis viruses that may persist in the body) makes your liver more vulnerable. Aging. As you age, your liver breaks down harmful substances more slowly. This means that toxins and their byproducts stay in your body longer. Drinking alcohol. Drinking alcohol while taking medications or certain herbal supplements increases the risk of toxicity. Being female. Because women seem to metabolize certain toxins more slowly than men do, their livers are exposed to higher blood concentrations of harmful substances for a longer time. This increases the risk of toxic hepatitis. Having certain genetic mutations. Inheriting certain genetic mutations that affect the production and action of the liver enzymes that break down toxins may make you more susceptible to toxic hepatitis. Working with industrial toxins. Working with certain industrial chemicals puts you at risk of toxic hepatitis.

• #1 World Hepatitis Day | Toxic hepatitis is one of the most common causes of acute liver failure, says doctor

  https://indianexpress.com/article/lifestyle/health-specials/toxic-hepatitis-acute-liver-failure-doctor-speaks-8056245/

  Toxic hepatitis can happen to anyone at any age because its occurrence primarily depends on the consumption of a toxic substance. […] The treatment includes specialised liver treatment, which involves stoppage of the toxic drugs. […] The protocol primarily includes stopping the drugs that cause liver damage, management of jaundice and liver damage, following standards for liver protocols in specialised liver units which include counteractive medicines, hepatic encephalopathy and antibiotics, if they have superadded infection.

• #1 Toxic hepatitis in occupational exposure to solvents

  https://www.wjgnet.com/1007-9327/full/v18/i22/2756.htm

  Some studies have suggested that exposure to organic solvents may induce liver toxicity because most chemicals are metabolized in the liver and toxic metabolites generated through the metabolism are the main cause of liver damage. […] Although a number of industrial chemicals are known to be hepatotoxins, liver disease from occupational exposure is rarely suspected or diagnosed. […] The most important factors contributing to toxicity liver are protein binding, species differences, points of binding inside the liver intracellular, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. […] The hepatotoxic effects of some of the solvents were recognized as early as 1887. […] Occupational toxic hepatitis can be divided into three types: hepatocellular, cholestatic and mixed.

• #1

  https://journals.lww.com/md-journal/fulltext/2016/01050/recurrent_acute_liver_failure_because_of_acute.33.aspx

  Diagnosis of occupational toxic hepatitis generally needs 3 criteria as follows: first, liver dysfunction should occur only after occupational exposure, with the medical history of occupational exposure at workplace; second, liver enzyme levels have to be greater than at least double the upper limit of normal range; third, other causes of liver damage such as viral infection and autoimmune hepatitis have to be excluded. […] the patient was eventually diagnosed with occupational toxic hepatitis because of organic solvent exposure. […] In conclusion, we report a case of recurrent acute liver failure caused by organic solvents. Toxic hepatitis because of organic solvents may recover spontaneously, but may also recur. Thus, it is important to consider the possibility of chemical exposure as the cause of acute liver failure as soon as possible, and to instruct the patient to avoid exposure.

• #1 Toxic hepatitis in occupational exposure to solvents

  https://www.wjgnet.com/1007-9327/full/v18/i22/2756.htm

  Toxic effects on the liver have been studied as early as 1887 and it was determined that there must be a change in the rate of the metabolism of these compound in order to create toxic products, otherwise toxicity will not occur. […] Clinical presentation of occupational liver disease may be acute/subacute or chronic but is often insidious. […] Since some of the solvents may cause chronic health effects, it may take decades to study and document such events. […] After steatosis, necrosis is the second most common effect of liver damage as a result of hepatotoxic solvents. […] Chronic effects on the liver in long-term occupational exposure to low levels of organic solvents remain undetermined. […] Many cases of liver cirrhosis with no known aetiology raise the suspicion that some may be of occupational origin.

• #1 Hepatitis: What Is It? Types, Symptoms, Causes, and More

  https://www.healthline.com/health/hepatitis

  Hepatitis may be caused by viral infection, alcohol consumption, several health conditions, or even some medications. […] These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. […] Excess alcohol consumption can cause liver damage and inflammation. This may also be referred to as alcoholic hepatitis. […] Other toxic causes of hepatitis include misuse of medications and exposure to toxins. […] In some cases, the immune system mistakes the liver as harmful and attacks it. This causes ongoing inflammation that can range from mild to severe, often hindering liver function.

• #1 Drug-Induced Liver Disease Types, Causes, Symptoms & Treatment

  https://www.medicinenet.com/drug_induced_liver_disease/article.htm

  The following drugs and chemicals can cause a wide spectrum of liver injury: Hepatitis (inflammation of liver cells), Necrosis (death of liver cells) often is caused by more severe hepatitis, Cholestasis (decreased secretion and/or flow of bile), Steatosis (accumulation of fat in the liver), Cirrhosis (advanced scarring of the liver) as a result of chronic hepatitis, cholestasis, or fatty liver. […] Certain drugs can cause acute and chronic hepatitis (inflammation of liver cells) that can lead to necrosis (death) of the cells. […] The most common example of drug-induced cirrhosis is alcoholic cirrhosis. Examples of drugs that can cause chronic liver diseases and cirrhosis include methotrexate (Rheumatrex), amiodarone (Cordarone), and methyldopa (Aldomet). […] Drugs can cause liver disease in several ways. Some drugs are directly injurious to the liver; others are transformed by the liver into chemicals that can cause injury to the liver directly or indirectly.

• #1 Drug-induced liver injury – UpToDate

  https://www.uptodate.com/contents/drug-induced-liver-injury

  Numerous drugs, both prescription and over-the-counter, herbal products, or toxins can cause hepatotoxicity through a variety of mechanisms. […] Drug-induced liver injury (DILI) and herbal-induced liver injury (HILI) are well-recognized and symptomatically can mimic both acute and chronic liver diseases. […] The probability of an individual drug causing liver injury ranges from 1 in 10,000 to 100,000, with some drugs reported as having an incidence of 100 in 100,000 (chlorpromazine, isoniazid). […] DILI accounts for approximately 10 percent of all cases of acute hepatitis, is the cause of acute jaundice in 50 percent of patients who present with new jaundice, and accounts for up to one-half of the cases of acute liver failure in Western countries. […] DILI is also the most frequently cited reason for withdrawal of medications from the marketplace (up to 32 percent of drug withdrawals). […] Several risk factors have been associated with the development of DILI, although their impact on DILI susceptibility has yet to be firmly established.

• #1 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Between 1998 and 2000, the US Food and Drug Administration (FDA) has recommended withdrawal of 2 drugs from the market for causing severe liver injury: bromfenac and troglitazone. […] Kava kava, an herb used for anxiety, was reported as being hepatotoxic and was withdrawn from the German market. […] The FDA has also issued a warning in the USA. […] Severe hepatic injury, including hepatic failure, has been reported in patients taking interferon beta-1a (Avonex), used in treatment of multiple sclerosis. […] In January 2006, the US Food and Drug Administration (FDA) issued a warning after 3 cases of serious liver toxicity were reported with taking telithromycin. […] In October 2005, the manufactures of duloxetine (an anti-depressant) reported postmarketing cases of hepatitis and cholestatic jaundice.

• #1 Drug-induced Hepatitis: Symptoms and Treatment | Doctor

  https://patient.info/doctor/drug-induced-hepatitis

  Drug-induced hepatitis involves inflammation of the liver, caused by medication. Drug-induced hepatitis is similar to acute viral hepatitis but parenchymal destruction tends to be more extensive. Certain drugs can cause damage to the liver in a variety of ways: […] Drug-induced liver injury can occur in overdose or at therapeutic dosing, either because of direct, intrinsic drug hepatotoxicity or as a result of idiosyncratic (unpredictable) hepatotoxicity. About 10% of cases are idiosyncratic. […] Drug-induced liver injury is the most common cause of acute liver failure in the western world. However idiosyncratic drug-induced liver injury is an uncommon adverse event when taking prescription or non-prescription medications. […] The development of drug-induced liver disease is dependent on the drug as well as individual patient factors, including genetic predisposition, age, gender, pre-existing liver disease and comorbidities.

• #1 Hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Hepatitis

  Herbal remedies and dietary supplements are another important cause of hepatitis; these are the most common causes of drug-induced hepatitis in Korea. […] Non-alcoholic hepatitis is within the spectrum of non-alcoholic liver disease (NALD), which ranges in severity and reversibility from non-alcoholic fatty liver disease (NAFLD) to non-alcoholic steatohepatitis (NASH) to cirrhosis to liver cancer, similar to the spectrum of alcoholic liver disease. […] Autoimmune hepatitis is a chronic disease caused by an abnormal immune response against liver cells. […] Genetic causes of hepatitis include alpha-1-antitrypsin deficiency, hemochromatosis, and Wilson’s disease. […] Ischemic hepatitis (also known as shock liver) results from reduced blood flow to the liver as in shock, heart failure, or vascular insufficiency.

• #1 Toxic hepatitis

  https://synevo.ge/en/toxic-hepatitis/

  Toxic liver damage, or toxic hepatitis, is a condition that occurs as a result of exposure to medications or various types of toxins. […] Medications, food additives, chemicals, solvents, and alcohol are the most common causes of toxic liver damage. […] Environmental toxins heavy metals, industrial chemicals, pesticides, and other air pollutants cause liver damage through various mechanisms, such as oxidative stress, inflammation, and direct cytotoxic effects. […] Hepatitis caused by chemicals: It is the result of direct contact with various poisons, inhalation, or ingestion. […] Drug-induced hepatitis: It is the result of taking a specific group of hepatotoxic medications (acetaminophen, nonsteroidal anti-inflammatory drugs, etc.). […] Alcoholic hepatitis: It develops as a result of alcohol and sometimes drug use.

• #1 Acute Liver Failure: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/177354-overview

  Autoimmune hepatitis may also result in hepatic failure. […] Many drugs (both prescription and illicit) are implicated in the development of fulminant hepatic failure. Drug-induced liver injury (DILI) is a leading cause of emergent liver transplantation; in Western nations, DILI is the primary cause of acute liver failure in adults. […] Acetaminophen (also known as paracetamol and N-acetyl-p-aminophenol [APAP]) may lead to liver failure as a result of intentional or accidental overdose. […] Chronic alcohol use may greatly increase the susceptibility to hepatotoxicity from acetaminophen because of depleted glutathione stores. […] The following toxins are associated with dose-related toxicity: Amanita phalloides mushroom toxin, Bacillus cereus toxin, Cyanobacteria toxin, Organic solvents (eg, carbon tetrachloride), Yellow phosphorus.

• #1 Hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Hepatitis

  Hepatitis is most commonly caused by the virus hepatovirus A, B, C, D, and E. […] Other common causes of hepatitis include heavy alcohol use, certain medications, toxins, other infections, autoimmune diseases, and non-alcoholic steatohepatitis (NASH). […] Many chemical agents, including medications, industrial toxins, and herbal and dietary supplements, can cause hepatitis. […] The spectrum of drug-induced liver injury varies from acute hepatitis to chronic hepatitis to acute liver failure. […] Toxins and medications can cause liver injury through a variety of mechanisms, including direct cell damage, disruption of cell metabolism, and causing structural changes. […] Many types of drugs can cause liver injury, including the analgesic paracetamol; antibiotics such as isoniazid, nitrofurantoin, amoxicillin-clavulanate, erythromycin, and trimethoprim-sulfamethoxazole; anticonvulsants such as valproate and phenytoin; cholesterol-lowering statins; steroids such as oral contraceptives and anabolic steroids; and highly active anti-retroviral therapy used in the treatment of HIV/AIDS.

• #1 Acute hepatitis – WikEM

  https://wikem.org/wiki/Acute_hepatitis

  Acetaminophen toxicity (most common cause of acute liver failure in the US) […] Liver damage from drugs or toxins may be cytotoxic from the primary drug or its metabolites, or may be caused by veno-occlusive disease or hypersensitivity disease. […] Common Drugs and Toxins include Acetaminophen, Amiodarone, Amphotericin, Anabolic steroids, Azathioprine, Carbamazepine, Chlorpromazine, Cisplatin, Contraceptives, Cyclophosphamide, Erythromycin, Gold salts, Haloperidol, Isoniazid, Ketoconazole, Lovastatin, Methotrexate, Methoxyflurane, Methyldopa, Phenobarbital, Phenytoin, Quinidine, Salicylates, Tetracycline, Valproic acid, Verapamil.

• #1 Alcoholic and Toxic Liver Disease | Nutrition Guide for Clinicians

  https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342081/all/Alcoholic_and_Toxic_Liver_Disease

  Hepatotoxic effects have been noted for weight loss aids, including usnic acid, 1,3-dimethylamylamine (1,3-DMAA), conjugated linoleic acid (CLA), garcinia cambogia, ma huang (Ephedra), and Herbalife products that contain mixtures of herbs. […] Kava is a botanical used for anxiolytic effects. It was withdrawn from the market in several countries after cases of severe liver injury had been established, despite clinical trials that were unable to demonstrate hepatotoxicity and systematic reviews and meta-analyses that found a positive benefit-to-risk ratio for kava in treating anxiety disorders.

• #1

  https://journals.lww.com/md-journal/fulltext/2016/01050/recurrent_acute_liver_failure_because_of_acute.33.aspx

  The authors present a case of recurrent acute liver failure because of occupational exposure to organic solvents. […] Although urine test results for organic solvents were negative, a second liver biopsy revealed severe infiltration of neutrophils, compatible with toxic hepatitis. […] Based on the pathology and detailed clinical course, including the patient’s high exposure to organic solvents since just before the first admission, and the spontaneous recovery of his liver damage in the absence of the exposure, he was diagnosed with toxic hepatitis. […] In acute liver failure with an undetermined etiology, clinicians should rule out organic solvent-induced hepatitis. […] First, the patient’s acute hepatitis resulted from exposure to organic solvents. […] To the best of our knowledge, there is no other reported case of recurrent acute hepatitis because of organic solvent exposure.

• #2 Toxic Hepatitis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/toxic-hepatitis

  The liver processes almost everything a person consumes, including chemicals, medications and alcohol. In some instances, these substances may cause serious injury to the liver, resulting in toxic hepatitis a condition that causes inflammation of the liver. […] Many medications have the potential to cause liver toxicity and carry a warning on their label to this effect. […] In rare instances, however, some patients have an idiosyncratic reaction to a drug, causing massive destruction of liver cells and rapidly developing liver failure. […] Despite their widespread availability, some herbs and nutritional supplements may cause toxic hepatitis. […] Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. […] The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement. […] Patients with end-stage cirrhosis from alcohol may be considered for transplantation.

• #2 Toxic hepatitis

  https://ask-ahd.ahdubai.com/con-20166943

  Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] Toxic hepatitis occurs when your liver develops inflammation because of exposure to a toxic substance. Toxic hepatitis may also develop when you take too much of a prescription or over-the-counter medication. […] Toxic hepatitis can be caused by: Alcohol. Heavy drinking over many years can lead to alcoholic hepatitis inflammation in the liver due to alcohol, which can lead to liver failure. Over-the-counter pain relievers. Nonprescription pain relievers such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can damage your liver, especially if taken frequently or combined with alcohol. Prescription medications. Some medications linked to serious liver injury include the statin drugs used to treat high cholesterol, the combination drug amoxicillin-clavulanate (Augmentin), phenytoin (Dilantin, Phenytek), azathioprine (Azasan, Imuran), niacin (Niaspan), ketoconazole, certain antivirals and anabolic steroids. There are many others. Herbs and supplements. Some herbs considered dangerous to the liver include aloe vera, black cohosh, cascara, chaparral, comfrey, kava and ephedra. There are many others. Children can develop liver damage if they mistake vitamin supplements for candy and take large doses. Industrial chemicals. Chemicals you may be exposed to on the job can cause liver injury. Common chemicals that can cause liver damage include the dry cleaning solvent carbon tetrachloride, a substance called vinyl chloride (used to make plastics), the herbicide paraquat and a group of industrial chemicals called polychlorinated biphenyls.

• #2 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure. Approximately 75% of the idiosyncratic drug reactions result in liver transplantation or death. Drug-induced hepatic injury is the most common reason cited for withdrawal of an approved drug, and one-third of all drugs withdrawn from the market are withdrawn for liver injury. […] Worldwide, amoxicillin-clavulonate is one of the drugs most responsible for drug-induced liver injury, while acetaminophen toxicity is the main cause of drug-induced liver injury in the United States. […] In the United States, approximately 2000 cases of acute liver failure occur annually and drugs account for over 50% of them (39% are due to acetaminophen, 13% are idiosyncratic reactions due to other medications). Drugs account for 2-5% of cases of patients hospitalized with jaundice and approximately 10% of all cases of acute hepatitis.

• #2 Can Medication Cause Liver Damage? | Austin Gastroenterology

  https://www.austingastro.com/2018/04/27/can-medication-cause-liver-damage/

  Toxic hepatitis is caused by inflammation of the liver due to exposure to a toxic substance, such as over-consumption of prescription or over-the-counter medications, herbal medicines, or supplements. […] 900+ drugs, toxins, and herbs have been listed by the FDA as injurious to the liver. 20-40% of hepatic failures are attributable to drugs. Approximately 75% of drug reactions result in the need for liver transplantation or death. […] Toxic hepatitis can develop within hours or days of exposure. Or it may take months before any symptoms appear. […] Toxic hepatitis can permanently damage your liver, causing irreversible scarring of liver tissue (cirrhosis) and liver failure, which can be life threatening. […] Toxic hepatitis can be caused by: Long-term, heavy consumption can cause alcoholic hepatitis — alcohol-induced inflammation of the liver. Over-the-counter pain relievers. Nonprescription pain relievers such as acetaminophen, aspirin, ibuprofen and naproxen can damage your liver, especially if taken frequently or when combined with alcohol. Prescription medications. Statin drugs for high cholesterol, the combination drug amoxicillin-clavulanate, phenytoin, azathioprine, niacin, ketoconazole, certain antivirals, and anabolic steroids among many others. Herbs and supplements. Aloe Vera, black cohosh, cascara, chaparral, comfrey, kava and ephedra are some of the herbs and supplements considered dangerous for the liver.

• #2 Alcoholic hepatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/alcoholic-hepatitis/symptoms-causes/syc-20351388

  Alcoholic hepatitis is swelling, called inflammation, of the liver caused by drinking alcohol. Drinking alcohol destroys liver cells. […] Alcoholic hepatitis is caused by damage to the liver from drinking alcohol. Just how alcohol damages the liver and why it does so only in some heavy drinkers isn’t clear. […] These factors are known to play a role in alcoholic hepatitis: The body’s way of breaking down alcohol makes highly toxic chemicals. These chemicals trigger swelling, called inflammation, that destroys liver cells. Over time, scars replace healthy liver tissue. This keeps the liver from working well. This scarring, called cirrhosis, can’t be fixed. It’s the final stage of alcoholic liver disease. […] Other factors that can be involved with alcoholic hepatitis include: Other types of liver disease. Alcoholic hepatitis can make chronic liver diseases worse. For instance, if you have hepatitis C and drink, even a little, you’re more likely to get liver scarring than if you don’t drink. Lack of nutrition. Many people who drink heavily don’t get enough nutrients because they eat poorly. And alcohol keeps the body from using nutrients as it should. Lack of nutrients can damage liver cells.

• #2 Toxic hepatitis in occupational exposure to solvents

  https://www.wjgnet.com/1007-9327/full/v18/i22/2756.htm

  Some studies have suggested that exposure to organic solvents may induce liver toxicity because most chemicals are metabolized in the liver and toxic metabolites generated through the metabolism are the main cause of liver damage. […] Although a number of industrial chemicals are known to be hepatotoxins, liver disease from occupational exposure is rarely suspected or diagnosed. […] The most important factors contributing to toxicity liver are protein binding, species differences, points of binding inside the liver intracellular, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. […] The hepatotoxic effects of some of the solvents were recognized as early as 1887. […] Occupational toxic hepatitis can be divided into three types: hepatocellular, cholestatic and mixed.

• #2 Drug-induced liver injury – UpToDate

  https://www.uptodate.com/contents/drug-induced-liver-injury

  Numerous drugs, both prescription and over-the-counter, herbal products, or toxins can cause hepatotoxicity through a variety of mechanisms. […] Drug-induced liver injury (DILI) and herbal-induced liver injury (HILI) are well-recognized and symptomatically can mimic both acute and chronic liver diseases. […] The probability of an individual drug causing liver injury ranges from 1 in 10,000 to 100,000, with some drugs reported as having an incidence of 100 in 100,000 (chlorpromazine, isoniazid). […] DILI accounts for approximately 10 percent of all cases of acute hepatitis, is the cause of acute jaundice in 50 percent of patients who present with new jaundice, and accounts for up to one-half of the cases of acute liver failure in Western countries. […] DILI is also the most frequently cited reason for withdrawal of medications from the marketplace (up to 32 percent of drug withdrawals). […] Several risk factors have been associated with the development of DILI, although their impact on DILI susceptibility has yet to be firmly established.

• #2 Toxic Hepatitis | UCSF Department of Surgery

  https://transplantsurgery.ucsf.edu/condition/toxic-hepatitis

  The liver processes almost everything a person consumes, including chemicals, medications and alcohol. In some instances, these substances may cause serious injury to the liver, resulting in toxic hepatitis – a condition that causes inflammation of the liver. […] Many medications have the potential to cause liver toxicity and carry a warning on their label to this effect. […] In rare instances, however, some patients have an idiosyncratic reaction to a drug, causing massive destruction of liver cells and rapidly developing liver failure. […] Despite their widespread availability, some herbs and nutritional supplements may cause toxic hepatitis. […] Alcohol abuse is well known to cause liver damage, but the extent of injury varies widely among people who drink to excess. […] The first and most important step in treating toxic hepatitis is to identify and eliminate the substance that is causing the problem, such as medications, herbs or alcohol. […] Urgent liver transplantation should be considered for patients with life-threatening liver damage caused by a medication, herb or nutritional supplement.

• #2 Toxic hepatitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/toxic-hepatitis

  Toxic hepatitis is an inflammation of your liver in reaction to certain substances to which you’re exposed. Toxic hepatitis can be caused by alcohol, chemicals, drugs or nutritional supplements. […] Toxic hepatitis occurs when your liver develops inflammation because of exposure to a toxic substance. Toxic hepatitis may also develop when you take too much of a prescription or over-the-counter medication. […] Toxic hepatitis can be caused by: Alcohol. Heavy drinking over many years can lead to alcoholic hepatitis inflammation in the liver due to alcohol, which can lead to liver failure. […] Over-the-counter pain relievers. Nonprescription pain relievers such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can damage your liver, especially if taken frequently or combined with alcohol.

• #2 Drugs and Chemicals That Cause Toxic Liver Disease

  https://www.webmd.com/fatty-liver-disease/toxic-liver-disease

  Toxic liver disease, or drug-induced liver injury (DILI), is damage to your liver. Its also called hepatotoxicity or toxic hepatitis. It can cause serious symptoms or liver damage if you dont get help. […] Medications, herbal supplements, chemicals, solvents, and alcohol are all possible causes of hepatotoxicity. […] Toxic liver disease has many possible causes. Some are easier to spot than others: […] Many over-the-counter (OTC) and prescription medications can cause toxic liver disease. […] Some common herbs could cause toxic liver disease. […] Some workplace chemicals can harm your liver. […] More than 1,000 drugs can cause liver damage. Both prescription and nonprescription drugs can cause drug-induced liver injury (DILI).

• #2 Drug-Induced Hepatotoxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557535/

  There are patient risk factors associated with the development of DILI, which include female sex, older age, and increased body mass index (BMI). More than 1000 medications and herbal compounds are known to cause hepatotoxicity and can be found on a searchable database maintained by the National Institute of Diabetes and Digestive, and Kidney Diseases (NIDDK) called LiverTox. Intrinsic DILI is most commonly caused by acetaminophen, while it is less often seen in aspirin, tetracycline, and vitamin A. […] Idiosyncratic DILI cases are caused by: Antibiotics (45.4%): amoxicillin-clavulanate (most common), sulfamethoxazole-trimethoprim, ciprofloxacin, isoniazid (INH); Nonsteroidal anti-inflammatory drugs (NSAIDs); Herbal and dietary supplements (16.1%): green tea extract, anabolic steroids, multi-ingredient nutritional supplements; Cardiovascular drugs (10%): statins, amiodarone; Central nervous system (CNS) agents: valproate, phenytoin; Antineoplastic drugs: tyrosine kinase inhibitors, tumor necrosis factor inhibitors, alpha inhibitors, methotrexate. […] More than 1000 medications and herbal compounds can cause drug-induced hepatotoxicity.

• #2 Toxic Hepatitis

  https://mobile.fpnotebook.com/GI/Lvr/TxcHpts.htm

  Toxic Hepatitis, Drug-Induced Hepatitis, Drug Induced Liver Injury, Liver Injury Due to Medication, Toxic liver disease […] Causes […] Carbon tetrachloride […] Benzene derivative […] Mushroom Poisoning […] Herbal Toxicity […] Antiepileptics […] Amiodarone […] Methotrexate […] Acetaminophen (42% of acute liver injury in U.S.) […] Antibiotics (second most common cause in U.S.) […] Isoniazid […] Halothane […] Phenytoin […] Methyldopa.

• #2 Toxic hepatitis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/toxic-hepatitis

  Prescription medications. Some medications linked to serious liver injury include the statin drugs used to treat high cholesterol, the combination drug amoxicillin-clavulanate (Augmentin), phenytoin (Dilantin, Phenytek), azathioprine (Azasan, Imuran), niacin (Niaspan), ketoconazole, certain antivirals and anabolic steroids. There are many others. […] Herbs and supplements. Some herbs considered dangerous to the liver include aloe vera, black cohosh, cascara, chaparral, comfrey, kava and ephedra. There are many others. Children can develop liver damage if they mistake vitamin supplements for candy and take large doses. […] Industrial chemicals. Chemicals you may be exposed to on the job can cause liver injury. Common chemicals that can cause liver damage include the dry cleaning solvent carbon tetrachloride, a substance called vinyl chloride (used to make plastics), the herbicide paraquat and a group of industrial chemicals called polychlorinated biphenyls.

• #2 Drug-induced hepatitis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/drug-induced-hepatitis

  Toxic hepatitis; Drug-induced hepatitis; DILI. […] Drug-induced liver injury (DILI) is an injury of the liver that may occur when you take certain medicines. […] Many different drugs can cause drug-induced hepatitis. […] Painkillers and fever reducers that contain acetaminophen are a common cause of liver injury, particularly when taken in doses greater than those recommended. […] Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac, and naproxen, may also cause drug-induced hepatitis. […] Other drugs that can lead to liver injury include: Amiodarone, Anabolic steroids, Birth control pills, Chlorpromazine, Erythromycin, Halothane (a type of anesthesia), Methyldopa, Isoniazid, Methotrexate, Statins, Sulfa drugs, Tetracyclines, Amoxicillin-clavulanate, Some anti-seizure medicines, Disulfiram, Niacin, Azathoaprine, Ketoconazole.

• #2 Alcoholic and Toxic Liver Disease | Nutrition Guide for Clinicians

  https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342081/all/Alcoholic_and_Toxic_Liver_Disease

  Hepatotoxic effects have been noted for weight loss aids, including usnic acid, 1,3-dimethylamylamine (1,3-DMAA), conjugated linoleic acid (CLA), garcinia cambogia, ma huang (Ephedra), and Herbalife products that contain mixtures of herbs. […] Kava is a botanical used for anxiolytic effects. It was withdrawn from the market in several countries after cases of severe liver injury had been established, despite clinical trials that were unable to demonstrate hepatotoxicity and systematic reviews and meta-analyses that found a positive benefit-to-risk ratio for kava in treating anxiety disorders.

• #2

  https://www.aurorahealthcare.org/services/gastroenterology-colorectal-surgery/non-viral-hepatitis

  Toxic hepatitis is caused by chemicals, drugs (prescription and over-the-counter) and nutritional supplements. […] Treatment for toxic hepatitis may include: […] Stopping exposure to the substance that caused it. […] To prevent toxic hepatitis: […] If you work with hazardous chemicals, take every safety precaution to protect yourself from harmful exposure, and get emergency care if you are exposed.

• #2 Toxic hepatitis in occupational exposure to solvents

  https://www.wjgnet.com/1007-9327/full/v18/i22/2756.htm

  The solvents suspected to be responsible for liver occupational disease are: dimethylformamide (DMF), dimethylacetamide (DMA), trichloroethylene (TCE), tetrachloroethylene, carbon tetrachloride, xylene, toluene, and chloroform. […] It was found that 10% of workers exposed to TCE became jaundiced with massive hepatic necrosis. […] The data in humans, although limited, clearly suggests a toxic effect on human livers. Case reports describe TCE as inducing hepatitis and liver necrosis. […] Carbon tetrachloride is one of the most powerful solvents toxic to the liver, and is widely used in scientific research to assess liver damage and hepatoprotective agents. […] Indeed, carbon tetrachloride has been known for many years to be toxic to the liver. […] Hepatotoxicity has been observed in the literature in individuals exposed to xylene and toluene.

• #2 Liver Toxicity – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK526106/

  Additionally, herbal supplements cause a variety of symptoms, but their usage remains under-reported. […] Drug-induced liver injury is the most common cause of acute liver failure (ALF) in the United States and Europe and accounts for 20% to 40% of all instances of fulminant hepatic failure. […] Multiple risk factors like old age, female gender, chronic alcoholism, and pregnancy have been described in the literature to cause an increased risk of drug-induced liver injury. […] Some HLA types (human leukocyte antigen) serotypes have been identified as risk factors for drug-induced liver injury. […] Drug-induced liver injury can be dose-dependent/intrinsic, and on most occasions, it is dose-independent/idiosyncratic. […] Most other drugs cause a dose-independent pattern of hepatotoxicity.

• #2 Hepatitis: Causes and Risk Factors

  https://www.verywellhealth.com/hepatitis-causes-and-risk-factors-4689127

  Toxic hepatitis is when substances damage the liver and cause it to swell. The primary drivers behind toxic hepatitis are alcohol, toxic chemicals, and certain medications. […] Alcohol’s damaging impact on the liver is well documented, and alcoholic hepatitis is just one of many harmful conditions that can come as a result of long-term or heavy drinking. […] Repeated or excessive exposure to toxic chemicals like solvents or other organic chemicals can lead to toxic hepatitis, whether it be by ingesting, touching or breathing in the substances. […] Some over-the-counter and prescription medications can cause toxic hepatitis, including: Amiodarone, Amoxicillin-clavulanate, Anabolic steroids, Birth control medications, Chlorpromazine, Erythromycin, Halothane, Isoniazid, Methyldopa, Methotrexate, Nonsteroidal anti-inflammatory drugs (NSAIDs), Statins, Sulfa drugs, Tetracyclines, Some anti-seizure medications. […] In some cases, use of the above medications (especially in high doses) might trigger hepatitis in people who are already susceptible, such as those with other underlying liver disease.

• #2 Hepatotoxicity – Wikipedia

  https://en.wikipedia.org/wiki/Hepatotoxicity

  Hepatotoxicity implies chemical-driven liver damage. Drug-induced liver injury (DILI) is a cause of acute and chronic liver disease caused specifically by medications and the most common reason for a drug to be withdrawn from the market after approval. […] Chemicals that cause liver injury are called hepatotoxins. More than 900 drugs have been implicated in causing liver injury and it is the most common reason for a drug to be withdrawn from the market. Hepatotoxicity and drug-induced liver injury also account for a substantial number of compound failures, highlighting the need for toxicity prediction models, and drug screening assays, such as stem cell-derived hepatocyte-like cells, that are capable of detecting toxicity early in the drug development process. […] Adverse drug reactions are classified as type A (intrinsic or pharmacological) or type B (idiosyncratic). Type A drug reaction accounts for 80% of all toxicities.

• #2 Alcoholic and Toxic Liver Disease | Nutrition Guide for Clinicians

  https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342081/all/Alcoholic_and_Toxic_Liver_Disease

  Hepatotoxicity from use of herbal and dietary supplements accounts for about 20% of all cases of drug-induced liver injury and may be the most common serious adverse effect of herbal supplements. Known hepatotoxic herbs causing liver injury include certain ayurvedic herbs, black cohosh, kava, pennyroyal oil, ma huang (Ephedra sinica), valerian, mistletoe, comfrey, chaparral, sassafras, borage, and germander. Herb-induced liver injury is a diagnosis of exclusion as the clinical presentation is not specific and may be attributed to a variety of other conditions. […] Acetaminophen toxicity is greatly increased with the concomitant ingestion of alcohol. […] High doses of preformed vitamin A can be hepatotoxic, as can certain botanicals. […] Some herbal supplements, particularly those from China and India, have been found to induce hepatoxicity as a result of improper extraction methods and contamination with heavy metals (mainly mercury, lead, arsenic, cadmium), among other causes.

• #3 Liver Toxic Drugs: Types and Complications

  https://www.healthline.com/health/liver-toxic-drugs

  Many types of over-the-counter and prescription drugs can be toxic to your liver. Damage can be mild and reversible or severe and possibly life threatening. […] Drug-induced liver injury is the most common cause of sudden liver failure in the United States and Europe. […] In North America and Europe, the most common cause of toxic hepatitis is acetaminophen (Tylenol). Acetaminophen is harmless at low doses but can cause life threatening liver damage in high amounts. […] Many types of drugs can cause liver damage. In a 2016 study published in the International Journal of Molecular Sciences, researchers found at least one report of liver toxicity in 53% of drugs in the National Institutes of Healths LiverTox database. […] The most common cause of drug-induced liver injury in the United States is acetaminophen, usually at doses over 7.5 grams.

• #3 Hepatitis: Causes and Risk Factors

  https://www.verywellhealth.com/hepatitis-causes-and-risk-factors-4689127

  Toxic hepatitis is when substances damage the liver and cause it to swell. The primary drivers behind toxic hepatitis are alcohol, toxic chemicals, and certain medications. […] Alcohol’s damaging impact on the liver is well documented, and alcoholic hepatitis is just one of many harmful conditions that can come as a result of long-term or heavy drinking. […] Repeated or excessive exposure to toxic chemicals like solvents or other organic chemicals can lead to toxic hepatitis, whether it be by ingesting, touching or breathing in the substances. […] Some over-the-counter and prescription medications can cause toxic hepatitis, including: Amiodarone, Amoxicillin-clavulanate, Anabolic steroids, Birth control medications, Chlorpromazine, Erythromycin, Halothane, Isoniazid, Methyldopa, Methotrexate, Nonsteroidal anti-inflammatory drugs (NSAIDs), Statins, Sulfa drugs, Tetracyclines, Some anti-seizure medications. […] In some cases, use of the above medications (especially in high doses) might trigger hepatitis in people who are already susceptible, such as those with other underlying liver disease.

• #3 Can Medication Cause Liver Damage? | Austin Gastroenterology

  https://www.austingastro.com/2018/04/27/can-medication-cause-liver-damage/

  Toxic hepatitis is caused by inflammation of the liver due to exposure to a toxic substance, such as over-consumption of prescription or over-the-counter medications, herbal medicines, or supplements. […] 900+ drugs, toxins, and herbs have been listed by the FDA as injurious to the liver. 20-40% of hepatic failures are attributable to drugs. Approximately 75% of drug reactions result in the need for liver transplantation or death. […] Toxic hepatitis can develop within hours or days of exposure. Or it may take months before any symptoms appear. […] Toxic hepatitis can permanently damage your liver, causing irreversible scarring of liver tissue (cirrhosis) and liver failure, which can be life threatening. […] Toxic hepatitis can be caused by: Long-term, heavy consumption can cause alcoholic hepatitis — alcohol-induced inflammation of the liver. Over-the-counter pain relievers. Nonprescription pain relievers such as acetaminophen, aspirin, ibuprofen and naproxen can damage your liver, especially if taken frequently or when combined with alcohol. Prescription medications. Statin drugs for high cholesterol, the combination drug amoxicillin-clavulanate, phenytoin, azathioprine, niacin, ketoconazole, certain antivirals, and anabolic steroids among many others. Herbs and supplements. Aloe Vera, black cohosh, cascara, chaparral, comfrey, kava and ephedra are some of the herbs and supplements considered dangerous for the liver.

• #3 Toxic hepatitis in occupational exposure to solvents

  https://www.wjgnet.com/1007-9327/full/v18/i22/2756.htm

  The solvents suspected to be responsible for liver occupational disease are: dimethylformamide (DMF), dimethylacetamide (DMA), trichloroethylene (TCE), tetrachloroethylene, carbon tetrachloride, xylene, toluene, and chloroform. […] It was found that 10% of workers exposed to TCE became jaundiced with massive hepatic necrosis. […] The data in humans, although limited, clearly suggests a toxic effect on human livers. Case reports describe TCE as inducing hepatitis and liver necrosis. […] Carbon tetrachloride is one of the most powerful solvents toxic to the liver, and is widely used in scientific research to assess liver damage and hepatoprotective agents. […] Indeed, carbon tetrachloride has been known for many years to be toxic to the liver. […] Hepatotoxicity has been observed in the literature in individuals exposed to xylene and toluene.

• #3 Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease

  https://emedicine.medscape.com/article/169814-overview

  Some drugs appear to have different toxicities based on race. […] Elderly persons are at increased risk of hepatic injury because of decreased clearance, drug-to-drug interactions, reduced hepatic blood flow, variation in drug binding, and lower hepatic volume. […] Alcoholic persons are susceptible to drug toxicity because alcohol induces liver injury and cirrhotic changes that alter drug metabolism. […] Preexisting liver disease has not been thought to make patients more susceptible to drug-induced liver injury, but it may be that a diminished liver reserve or the ability to recover could make the consequences of injury worse. […] The pathophysiologic mechanisms of hepatotoxicity are still being explored and include both hepatocellular and extracellular mechanisms. […] The classic division of drug reactions is into at least two major groups, (1) drugs that directly affect the liver and (2) drugs that mediate an immune response.

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