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Severe Acute Hepatocellular Injury Attributed to OxyELITE Pro: A Case Series.

ABSTRACT: BACKGROUND/AIM:Herbal and dietary supplement (HDS) hepatotoxicity is increasingly being reported in the USA. This case series describes the presenting clinical features and outcomes of seven patients with liver injury attributed to OxyELITE Pro enrolled in the Drug-Induced Liver Injury Network (DILIN) study. METHODS:The 6-month outcomes of patients with hepatotoxicity attributed to OxyELITE Pro enrolled in the DILIN prospective registry between 2004 and 2015 are presented. RESULTS:Six of the seven patients (86 %) presented in 2013 with symptoms of hepatitis and acute hepatocellular injury. The median duration of OxyELITE Pro use was 18 weeks (range 5-102 weeks). Median age was 36 years (range 28-62), 86 % were female, and 43 % were Asian. One patient had rash, none had eosinophilia, and three had antinuclear antibody reactivity. The median peak ALT was 2242 U/L, alkaline phosphatase 284 U/L and bilirubin 15.0 mg/dL. Six patients (86 %) were hospitalized, three developed acute liver failure and two underwent liver transplantation. DILIN causality scores for OxyELITE Pro were definite in 1, highly likely in 3, probable in 2, and possible in 1. Four of the five patients without liver transplant recovered completely within 6 months, while one patient had mild residual ALT elevations. CONCLUSIONS:Seven cases of severe acute hepatocellular injury attributed to OxyELITE Pro are reported. These results reinforce the need to assess for HDS supplement use in patients presenting with unexplained acute hepatitis and point to the need for additional regulatory oversight of HDS products.

SUBMITTER: Heidemann LA

PROVIDER: S-EPMC4982804 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Severe Acute Hepatocellular Injury Attributed to OxyELITE Pro: A Case Series.

Heidemann Lauren A LA Navarro Victor J VJ Ahmad Jawad J Hayashi Paul H PH Stolz Andrew A Kleiner David E DE Fontana Robert J RJ

Digestive diseases and sciences 20160503 9

<h4>Background/aim</h4>Herbal and dietary supplement (HDS) hepatotoxicity is increasingly being reported in the USA. This case series describes the presenting clinical features and outcomes of seven patients with liver injury attributed to OxyELITE Pro enrolled in the Drug-Induced Liver Injury Network (DILIN) study.<h4>Methods</h4>The 6-month outcomes of patients with hepatotoxicity attributed to OxyELITE Pro enrolled in the DILIN prospective registry between 2004 and 2015 are presented.<h4>Resu ...[more]

PMID: 27142670

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Project description:BackgroundAcute Kidney Injury (AKI) is a major and under-recognised cause of morbidity and mortality worldwide. Low and middle-income countries bear the greatest burden of AKI (85%). There is currently no published literature on AKI from the Pacific Islands. The aim of the present study was to report the incidence, aetiology, management and outcomes measures of AKI from the tertiary referral hospital of Samoa.Materials and methodsSingle-centre prospective observational study. Participants were recruited by the lead investigator from the hospital patient information system. The inclusion criteria for participation was (1) adults (>18 years) admitted to general wards of Tupua Tamasese Meaole (TTM) Hospital with a diagnosis of AKI between December 1, 2019 and May 31, 2020, and (2) serum creatinine level of >200 μmol/L, and (3) compliance with the current Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI diagnosis. The data collection form was adapted from the International Society for Nephrology - Global Snapshot Project, and recorded demographic and baseline characteristics, precipitating causes of AKI, treatment/management, and outcomes measures.ResultsThere was a total of 114 AKI admissions over the study period corresponding to a hospital-based AKI incidence of 26.8 per 1000 admissions per 6 months. 75% of AKI cases were community acquired. The leading causes of AKI were dehydration (79%) and sepsis (64%). More than 40% of cases presented with two or more Non-Communicable Disease co-morbidities. The in-patient mortality rate was 20.2%. In the 3 months following discharge from hospital, 25% of AKI cases had completely resolved, 25% of patients had died, and 18.7% of AKI cases had progressed to chronic kidney disease. The leading causes of mortality were cardiovascular events (35%) and sepsis (35%).ConclusionsThe hospital-based incidence and unfavourable outcomes of AKI are high in Samoa. Greater awareness of this under-recognised condition is warranted among the public, government officers, and health professionals.

Dataset Information

Severe Acute Hepatocellular Injury Attributed to OxyELITE Pro: A Case Series.

Publications

Severe Acute Hepatocellular Injury Attributed to OxyELITE Pro: A Case Series.

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