Browsing by Author "Medina-Caliz, Inmaculada"

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    Herbal and Dietary Supplements-Induced Liver Injury in Latin America: Experience From the LATINDILI Network
    (2022) Bessone, Fernando; Garcia-Cortes, Miren; Medina-Caliz, Inmaculada; Hernandez, Nelia; Parana, Raymundo; Mendizabal, Manuel; Schinoni, Maria, I; Ridruejo, Ezequiel; Nunes, Vinicius; Peralta, Mirta; Santos, Genario; Anders, Margarita; Chiodi, Daniela; Tagle, Martin; Montes, Pedro; Carrera, Enrique; Arrese, Marco; Isabel Lizarzabal, M.; Alvarez-Alvarez, Ismael; Caballano-Infantes, Estefania; Niu, Hao; Pinazo, Jose; Cabello, Maria R.; Isabel Lucena, M.; Andrade, Raul J.
    BACKGROUND: Herbal and dietary supplements (HDS) consumption, a growing cause of hepatotoxicity, is a common practice among Latin-American populations. Objectives: To evaluate clinical, laboratory features and outcome in HDS-hepatotoxicity included in the Latin America-Drug Induced Liver Injury (LATINDILI) Network.
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    Nitrofurantoin-induced liver injury: long-term follow-up in two prospective DILI registries
    (2023) Bessone, Fernando; Ferrari, Antonella; Hernandez, Nelia; Mendizabal, Manuel; Ridruejo, Ezequiel; Zerega, Alina; Tanno, Federico; Reggiardo, Maria Virginia; Vorobioff, Julio; Tanno, Hugo; Arrese, Marco; Nunes, Vinicius; Tagle, Martin; Medina-Caliz, Inmaculada; Robles-Diaz, Mercedes; Niu, Hao; Alvarez-Alvarez, Ismael; Stephens, Camilla; Lucena, M. Isabel; Andrade, Raul J.
    Nitrofurantoin is a synthetic antibiotic that is recommended as first-choice treatment for uncomplicated urinary tract infections. The prescription of this drug has increased dramatically, especially in Latin American countries. We described the demographics, clinical characteristics, biochemical features, and outcome of nitrofurantoin-induced liver injury. We analyzed 23 cases from the Latin American DILI Network (LATINDILI) and the Spanish DILI Registry. Causality was assessed with the RUCAM and RECAM scale. Of the 23 DILI cases included in our series, 96% patients were women, and the mean age of the whole cohort was 61 years. The median time of drug exposure was 175 days (interquartile range [IQR] 96-760), with 11 patients who were prescribed nitrofurantoin for more than six months. Hepatocellular damage was the most frequent pattern of liver injury (83%), and nearly half of the patients had an asymptomatic presentation (52%). Neither death nor liver transplantation was documented in this series. Overall, 65% of the patients (n = 15) presented with positive autoantibody titres. The median time to resolution was 81 days (IQR 57-141), and 15 patients (83%) recovered within six months. Five patients (22%) developed nitrofurantoin-induced autoimmune-like hepatitis (NI-AILH), of whom two were characterized by a persistent increase in transaminases that required immunosuppressive treatment to achieve normalization of liver enzymes. Clinicians who prescribe nitrofurantoin should be aware that patients who had taken nitrofurantoin for a long term may be at risk of developing nitrofurantoin-induced autoimmune-like hepatitis.
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    Serious liver injury induced by Nimesulide: an international collaborative study
    (2021) Bessone, Fernando; Hernandez, Nelia; Mendizabal, Manuel; Ridruejo, Ezequiel; Gualano, Gisela; Fassio, Eduardo; Peralta, Mirta; Fainboim, Hugo; Anders, Margarita; Tanno, Hugo; Tanno, Federico; Parana, Raymundo; Medina-Caliz, Inmaculada; Robles-Diaz, Mercedes; Alvarez-Alvarez, Ismael; Niu, Hao; Stephens, Camilla; Colombato, Luis; Arrese, Marco; Reggiardo, M. Virginia; Ono, Suzane Kioko; Carrilho, Flair; Lucena, M. Isabel; Andrade, Raul J.
    Nimesulide is a non-steroidal anti-inflammatory drug still marketed in many countries. We aim to analyze the clinical phenotype, outcome, and histological features of nimesulide-induced liver injury (nimesulide-DILI). We analyzed 57 cases recruited from the Spanish and Latin American DILI registries. Causality was assessed by the RUCAM scale. Mean age of the whole case series was 59 years (86% women) with a median time to onset of 40 days. A total of 46 patients (81%) were jaundiced. Nimesulide-DILI pattern was hepatocellular in 38 (67%), mixed in 12 (21%), and cholestatic in 7 (12%) cases. Transaminases were elevated with a mean of nearly 20-fold the upper limit of normality (ULN), while alkaline phosphatase showed a twofold mean elevation above ULN. Total bilirubin showed a mean elevation of 13-fold the ULN. Liver histology was obtained in 14 cases (25%), most of them with a hepatocellular pattern. Median time to recovery was 60 days. Overall, 12 patients (21%) developed acute liver failure (ALF), five (8.8%) died, three underwent liver transplantation (5.3%), and the remaining four resolved. Latency was <= 15 days in 12 patients (21%) and one patient developed ALF within 7 days from treatment initiation. Increased total bilirubin and aspartate transaminase levels were independently associated with the development of ALF. In summary, nimesulide-DILI affects mainly women and presents typically with a hepatocellular pattern. It is associated with ALF and death in a high proportion of patients. Shorter (<= 15 days) duration of therapy does not prevent serious nimesulide hepatotoxicity, making its risk/benefit ratio clearly unfavorable.
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    The influence of drug properties and host factors on delayed onset of symptoms in drug-induced liver injury
    (2019) González-Jiménez, Andrés; McEuen, Kristin; Chen, Minjun; Suzuki, Ayako; Robles-Díaz, Mercedes; Medina-Caliz, Inmaculada; Bessone, Fernando; Hernández, Nelia; Arrese Jiménez, Marco; Parana, Raimundo; Lucena, María Isabel; Stephens, Camila; Andrade, Raúl J.