Drug-induced illness liver

In a study using the UK General Practice Research Database to determine rates of drug-induced, rare, serious adverse effects on the liver, kidneys, skin, or blood, occurring within 45 days of completing a prescription or refill in 54 803 users of either fluconazole or itraconazole, three had illnesses for which a fluconazole-induced cause could not be ruled out one with thrombocytopenia, one with neutropenia, and one with an abnormal liver function test just after receiving fluconazole (31). The rates were 2.8/100 000 prescriptions (95% Cl = 0.8, 10) for serious, adverse blood events and 1.4/100 000 prescriptions (95% Cl = 0.25, 8.2) for serious, adverse liver events. These results suggest that fluconazole does not commonly have serious adverse effects on the liver, kidneys, skin, or blood. 

The nutritional stams of a patient can be as important to the development of a drug-induced liver disease as the hepatotoxin itself." Patients who are malnourished because of illness or long-term alcohol abuse make up the most troublesome group." Low serum levels of vitamins E and C along with lutein and the a-and /3-carotenes are associated with asymptomatic elevations in transaminases. Conversely, high serum iron, transferrin, and selenium levels are also associated with asymptomatic elevations of transaminases." ... 

The low T3 syndrome is induced by a decrease in the production of plasma T3 as well as the clearance of plasma rT3 and is observed in several clinical situations such as starvation, systemic illness and the use of certain drugs [115]. In fasting [70] and illness [108] the abnormal thyroid hormone metabolism appears to result from a defective liver uptake and, therefore, a decreased supply of T4 and rT3 for intracellular deiodination. In other conditions such as treatment with PTU or propranolol [116], the defect appears localized in the type I deiodinase itself leading to a decline in T3 formation and rT3 breakdown. 

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