RESUMO
Se analizaron los datos epidemiológicos y clínico-evolutivos de la hepatotoxicidad por fármacos en una experiencia de 10 años (1988-1998) de nuestra Unidad de Hígado, que incluye 10342 historias clínicas de registro prospectivo. La prevalencia en este material fué de 5,6 por ciento, con ligero predominio femenino (1.4:1) y en mayores de 40 años; más del 50 por ciento ingirieron 2 o más fármacos. Predominaron las formas agudas (91.4 por ciento) e ictéricas (60.4 por ciento) con manifestaciones sistémicas de hipersensibilidad en 29.3 por ciento, el 4.5 por ciento de las formas agudas se presentaron como fallo hepático agudo severo, con necesidad de transplante hepático en un caso. los 4 casos de hepatitis crónica presentaron evolución a la cirrosis en un caso, y un caso de colestasis con ductopenia (CBP-simil) evolucionó favorablemente en 19 semanas, recibiendo ácido ursode-soxicólico 10 mg/k/día. Seis fármacos representaron el 53.4 por ciento de los casos: anticonceptivos orales, isoniacida, sulfamidas, clorpropamida, carbamacepina y amiodarona.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Hepatopatias/induzido quimicamente , Hepatopatias/epidemiologia , Doença Aguda , Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Anti-Infecciosos/efeitos adversos , Anticonvulsivantes/efeitos adversos , Antituberculosos/efeitos adversos , Carbamazepina/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Colestase/induzido quimicamente , Colestase/epidemiologia , Doença Crônica , Anticoncepcionais Orais/efeitos adversos , Hipoglicemiantes/efeitos adversos , Isoniazida/efeitos adversos , Prevalência , Sulfonas/efeitos adversosRESUMO
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8
respectively and that for HBs Ag was 21
of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6
in our Hospital and 54.8
in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49
were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)