Análisis de las causas, características y consecuencias de la reexposición al fármaco o compuesto responsable de un episodio de hepatotoxicidad

Introduction: reexposure to a causal agent represents a po tentially serious event in hepatotoxicity. Objectives: to assess the characteristics and outcome of cas es with positive reexposure. Material and methods: a retrospective study of cases with evidence of positive reexposure included in Registro Espanol de Hepatopatias Asociadas a Medicamentos, and an analysis of their relation to demographic and clinical variables, causality, course, and consequences. Results: of a total of 520 cases 31 (6%) met reexposure crite ria. Fatal outcomes, needs for admission, and mean recovery time were all higher for hepatocellular-type toxic injury. The most com monly identified drug class was antibiotics. On most occasions (73%) reexposure to the causal compound escaped notice be cause of: absence of index case diagnosis, lack of information to patients and their physicians, and (12%) development of cross re actions between structurally similar drugs. Conclusions: accidental reexposure to a drug or a structurally-related compound after an initial hepatotoxicity event is com mon and may have serious consequences, particularly in hepato cellular-type toxicity. Careful history taking and reflecting diagnostic suspicion in the initial episode’s record may reduce the incidence of this iatrogenic event.