{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:23:12Z","timestamp":1762017792300,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p>Drug-induced hepatotoxicity most commonly manifests as an acute hepatitis syndrome and remains the leading cause of drug-induced death\/mortality and the primary reason for withdrawal of drugs from the pharmaceutical market. We report a case of acute liver injury in a 12-year-old Hispanic boy, who received a series of five antibiotics (amoxicillin, ceftriaxone, vancomycin, ampicillin\/sulbactam, and clindamycin) for cervical lymphadenitis\/retropharyngeal cellulitis. Histopathology of the liver biopsy specimen revealed acute cholestatic hepatitis. All known causes of acute liver injury were appropriately excluded and (only) drug-induced liver injury was left as a cause of his cholestasis. Liver-specific causality assessment scales such as Council for the International Organization of Medical Sciences\/Roussel Uclaf Causality Assessment Method scoring system (CIOMS\/RUCAM), Maria and Victorino scale, and Digestive Disease Week-Japan were applied to seek the most likely offending drug. Although clindamycin is the most likely cause by clinical diagnosis, none of causality assessment scales aid in the diagnosis.<\/jats:p>","DOI":"10.1155\/2014\/156389","type":"journal-article","created":{"date-parts":[[2014,11,24]],"date-time":"2014-11-24T16:00:21Z","timestamp":1416844821000},"page":"1-7","source":"Crossref","is-referenced-by-count":1,"title":["A Challenge for Diagnosing Acute Liver Injury with Concomitant\/Sequential Exposure to Multiple Drugs: Can Causality Assessment Scales Be Utilized to Identify the Offending Drug?"],"prefix":"10.1155","volume":"2014","author":[{"given":"Roxanne","family":"Lim","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6720-724X","authenticated-orcid":true,"given":"Hassan","family":"Choudry","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Conner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wikrom","family":"Karnsakul","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"year":"1999","key":"1"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(90)90124-A"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.02.007"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(93)90101-6"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(93)90102-7"},{"key":"6","first-page":"77","volume":"32","year":"2000","journal-title":"Journal of Hepatology"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2007.06.001"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200225100-00006"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1240003"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2007.06.003"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03655.x"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-6346(03)00232-8"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1240008"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1179\/1973947813Y.0000000090"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1086\/338047"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i40.5408"},{"issue":"8","key":"17","first-page":"1230","volume":"89","year":"1994","journal-title":"The American Journal of Gastroenterology"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31821d6cfd"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.3350\/kjhep.2011.17.3.229"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.2669"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1592\/phco.2005.25.10.1389"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.2165\/11539560-000000000-00000"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E225"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23696"},{"key":"25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra021844"}],"container-title":["Case Reports in Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2014\/156389.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2014\/156389.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cripe\/2014\/156389.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T11:34:17Z","timestamp":1469705657000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/cripe\/2014\/156389\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014]]},"references-count":25,"alternative-id":["156389","156389"],"URL":"https:\/\/doi.org\/10.1155\/2014\/156389","relation":{},"ISSN":["2090-6803","2090-6811"],"issn-type":[{"type":"print","value":"2090-6803"},{"type":"electronic","value":"2090-6811"}],"subject":[],"published":{"date-parts":[[2014]]}}}