Severe Case of Cholestatic Hepatitis From Amoxicillin/Clavulanic Acid

Goyal, Lokesh; Madabhushi, Anirudh K; Siddiqi, Mariam S; Kale, Santosh; Mallick, Deobrat C.

doi:10.7759/cureus.25797

Cited by 1 publication

(1 citation statement)

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“…These results suggest that the induced hepatocellular damage affected liver bile function as well resulting in a greater or lesser extent of cholestasis. Amoxicillin-clavulanic typically induces cholestasis of severe phenotype [ 23 , 24 , 25 ]. However, the analysis of the plasma samples collected from DILI patients taking this drug showed a wide variability in the metabolic phenotype with individuals displaying from a cholestatic to a hepatocellular phenotype (see Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

Exploring Individual Variability in Drug-Induced Liver Injury (DILI) Responses through Metabolomic Analysis

Moreno-Torres,

Quintás,

Martínez-Sena

et al. 2024

IJMS

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Drug-induced liver injury (DILI) is a serious adverse hepatic event presenting diagnostic and prognostic challenges. The clinical categorization of DILI into hepatocellular, cholestatic, or mixed phenotype is based on serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) values; however, this classification may not capture the full spectrum of DILI subtypes. With this aim, we explored the utility of assessing changes in the plasma metabolomic profiles of 79 DILI patients assessed by the RUCAM (Roussel Uclaf Causality Assessment Method) score to better characterize this condition and compare results obtained with the standard clinical characterization. Through the identification of various metabolites in the plasma (including free and conjugated bile acids and glycerophospholipids), and the integration of this information into predictive models, we were able to evaluate the extent of the hepatocellular or cholestatic phenotype and to assign a numeric value with the contribution of each specific DILI sub-phenotype into the patient’s general condition. Additionally, our results showed that metabolomic analysis enabled the monitoring of DILI variability responses to the same drug, the transitions between sub-phenotypes during disease progression, and identified a spectrum of residual DILI metabolic features, which can be overlooked using standard clinical diagnosis during patient follow-up.

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Section: Resultsmentioning

confidence: 99%