Patients with a history of allergic reactions to drugs in cases of idiosyncratic drug-induced liver injury (DILI) are more likely to experience worse clinical outcomes, including death, according to new research presented at the EASL Congress. The study, which analyzed a large cohort of well-characterized DILI cases, found that patients with prior drug allergies tended to be older and had a higher prevalence of underlying chronic disease. Hepatocellular injury was the most common type of liver injury observed in both groups, but patients with prior drug allergies had lower alkaline phosphatase values and higher aspartate aminotransferase and alanine aminotransferase values. Additionally, patients with prior drug allergies had significantly lower platelet counts. Fatal outcomes were reported in nine patients with prior drug allergies who progressed to acute liver failure, highlighting the importance of a thorough pharmacologic history and screening for prior drug allergies in suspected DILI cases. The study also identified the drugs most responsible for DILI in patients with and without prior drug allergies. Overall, this research emphasizes the need for close monitoring and early detection of a worsening clinical course in DILI patients with a history of drug allergies.

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