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Drug-Induced
Liver Injury
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Adverse drug reactions in children are uncommon. Nevertheless, drug-induced
hepatotoxicity, when it occurs, must be promptly recognized, and
the offending agent discontinued, although cessation does not always
result in rapid recovery. Delays in recognizing hepatic injury may
significantly contribute to morbidity, resulting in a need for liver
transplantation or in death.1-5
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The role of the liver in the processing or biotransformation
of xenobiotics (foreign substances) is discussed in Chapter 418. Mechanisms of hepatoxicity vary, as they depend on the
drug, dosage, and patient factors such as age, gender, nutrition,
and genetic predisposition. In general, medicinal and environmental
agents known to cause hepatotoxicity have been characterized as
predictable (intrinsic) or unpredictable (idiosyncratic) hepatotoxins.
The patterns of liver injuries are clinically and histopathologically
diverse (Table 422-1).
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