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- W4386898678 abstract "Background Intravenous vancomycin therapy can cause liver injury as well as “drug-reaction with eosinophilia and systemic symptoms” (DRESS) syndrome. This study aimed to better define the clinical features and human leukocyte antigen (HLA) associations of vancomycin induced liver injury. Objective To describe clinical, biochemical, and temporal characteristics of vancomycin-induced liver injury Methods Cases of liver injury with recent exposure to vancomycin who were enrolled in the US Drug-induced Liver Injury Network between 2004 and 2020 were assessed. Sequencing of HLA alleles was performed on stored blood samples. Results Among 1697 cases of drug induced liver injury identified between 2004 and 2021, 9 (0.5%) were attributed to intravenous vancomycin. The 9 cases included 6 men, median age 60 years (range: 23-85), and treatment for 26 days (range 1 to 34). The clinical presentation was DRESS syndrome in 8 patients, of whom 6 received corticosteroids. Liver injury varied from hepatocellular to cholestatic and from mild (n=5) to fatal (n=1). In survivors, liver injury and DRESS ultimately resolved. HLA typing demonstrated the HLA-A*32:01 allele in 7 vancomycin cases (78%, all with DRESS), versus 1 of 81 cases (1.2%) exposed but not attributed to vancomycin, and 113 of 1708 cases (6.6%) without vancomycin exposure. The allele frequency in vancomycin cases was 0.44 compared to less than 0.04 in US populations. Conclusions Vancomycin-induced liver injury is commonly associated with DRESS and linked to HLA-A*32:01. HLA-A*32:01 testing could be considered early to risk-stratify patients using long term intravenous vancomycin therapy." @default.
- W4386898678 created "2023-09-21" @default.
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- W4386898678 date "2023-09-01" @default.
- W4386898678 modified "2023-10-16" @default.
- W4386898678 title "Vancomycin-Induced Liver Injury, DRESS, and HLA-A*32:01" @default.
- W4386898678 doi "https://doi.org/10.1016/j.jaip.2023.09.011" @default.
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