Acute Liver Failure of Indeterminate Etiology: A Comprehensive Systematic Approach by An Expert Committee to Establish Causality

Ganger, Daniel; Rule, Jody; Rakela, Jorge; Bass, Nathan M.; Reuben, Adrian; Stravitz, R. Todd; Sussman, Norman; Larson, Anne M.; James, Laura P.; Chiu, Charles Y.; Lee, William M.

doi:10.1038/s41395-018-0160-2

Cited by 75 publications

(91 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…89,[97][98][99][100][101][102][103][104][105][106] In humans, it is estimated that herbal and dietary supplements are responsible for up to 18% of drug-induced liver injury (refer to https://livertox.nih.gov/). [107][108][109][110][111] There are several anecdotal but poorly documented reports of liver injury in dogs given herbals or nutritional supplements. Clinicians should be vigilant in obtaining a complete drug history, including nontraditional therapies.…”

Section: Drugs and Toxinsmentioning

confidence: 99%

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Webster

Cullen

Penninck

et al. 2019

Veterinary Internal Medicne

198

View full text Add to dashboard Cite

This consensus statement on chronic hepatitis (CH) in dogs is based on the expert opinion of 7 specialists with extensive experience in diagnosing, treating, and conducting clinical research in hepatology in dogs. It was generated from expert opinion and information gathered from searching of PubMed for manuscripts on CH, the Veterinary Information Network for abstracts and conference proceeding from annual meetings of the American College of Veterinary Medicine and the European College of Veterinary Medicine, and selected manuscripts from the human literature on CH. The panel recognizes that the diagnosis and treatment of CH in the dog is a complex process that requires integration of clinical presentation with clinical pathology, diagnostic imaging, and hepatic biopsy. Essential to this process is an index of suspicion for CH, knowledge of how to best collect tissue samples, access to a pathologist with experience in assessing hepatic histopathology, knowledge of reasonable medical interventions, and a strategy for monitoring treatment response and complications.

show abstract

Section: Drugs and Toxinsmentioning

confidence: 99%

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Webster

Cullen

Penninck

et al. 2019

Veterinary Internal Medicne

198

View full text Add to dashboard Cite

show abstract

“…Intrinsic DILI is caused by drug overdose, with paracetamol (acetaminophen, N-acetyl-p-aminophenol, APAP, Tylenol ® ) as the most common drug responsible [5][6][7][36][37][38][39][40][41][42][43]. Occasionally, other drugs like amiodarone, anabolic steroids, cyclosporine, valproic acid, heparins, nicotinic acid, methotrexate, and tacrine have also been assumed to cause intrinsic DILI, with rare acute intoxications.…”

Section: Critical Issues In Clinical Settingsmentioning

confidence: 99%

Diagnostic Biomarkers in Liver Injury by Drugs, Herbs, and Alcohol: Tricky Dilemma after EMA Correctly and Officially Retracted Letter of Support

Teschke

Eickhoff

Brown

et al. 2019

IJMS

View full text Add to dashboard Cite

Liver injuries caused by the use of exogenous compounds such as drugs, herbs, and alcohol are commonly well diagnosed using laboratory tests, toxin analyses, or eventually reactive intermediates generated during metabolic degradation of the respective chemical in the liver and subject to covalent binding by target proteins. Conditions are somewhat different for idiosyncratic drug induced liver injury (DILI), for which metabolic intermediates as diagnostic aids are rarely available. Although the diagnosis of idiosyncratic DILI can well be established using the validated, liver specific, structured, and quantitative RUCAM (Roussel Uclaf Causality Assessment Method), there is an ongoing search for new diagnostic biomarkers that could assist in and also confirm RUCAM-based DILI diagnoses. With respect to idiosyncratic DILI and following previous regulatory letters of recommendations, selected biomarkers reached the clinical focus, including microRNA-122, microRNA-192, cytokeratin analogues, glutamate dehydrogenase, total HMGB-1 (High Mobility Group Box), and hyperacetylated HMGB-1 proteins. However, the new parameters total HMGB-1, and even more so the acetylated HMGB-1, came under critical scientific fire after misconduct at one of the collaborating partner centers, leading the EMA to recommend no longer the exploratory hyperacetylated HMGB1 isoform biomarkers in clinical studies. The overall promising nature of the recommended biomarkers was considered by EMA as highly dependent on the outstanding results of the now incriminated biomarker hyperacetylated HMGB-1. The EMA therefore correctly decided to officially retract its Letter of Support affecting all biomarkers listed above. New biomarkers are now under heavy scrutiny that will require re-evaluations prior to newly adapted recommendations. With Integrin beta 3 (ITGB3), however, a new diagnostic biomarker may emerge, possibly being drug specific but tested in only 16 patients; due to substantial remaining uncertainties, final recommendations would be premature. In conclusion, most of the currently recommended new biomarkers have lost regulatory support due to scientific misconduct, requiring now innovative approaches and re-evaluation before they can be assimilated into clinical practice.

show abstract

“…ALF in children reflects a variety of causes, and identification of the etiology impacts management . Prompt distinction between those with known causes and the really indeterminate cases is crucial …”

Section: Results Of 2 Studies On Children With Cld Presenting As Alfmentioning

confidence: 99%

Acute Liver Failure in Children: Is It Time to Revise the Diagnostic Criteria?

Giorgio

D’Antiga

2020

Liver Transpl

View full text Add to dashboard Cite

Acute Liver Failure of Indeterminate Etiology: A Comprehensive Systematic Approach by An Expert Committee to Establish Causality

Abstract: The indeterminate etiology in ALF includes patients with a diagnosis that is discernible after closer examination. Revision of etiologic diagnoses of indeterminate cases using added testing and expert opinion is useful in understanding all aspects of ALF.

Cited by 75 publications

References 31 publications

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

Diagnostic Biomarkers in Liver Injury by Drugs, Herbs, and Alcohol: Tricky Dilemma after EMA Correctly and Officially Retracted Letter of Support

Acute Liver Failure in Children: Is It Time to Revise the Diagnostic Criteria?

Contact Info

Product

Resources

About