{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:39:44Z","timestamp":1785436784739,"version":"3.56.0"},"reference-count":52,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011576","name":"Inonu University","doi-asserted-by":"publisher","award":["2026\/4934"],"award-info":[{"award-number":["2026\/4934"]}],"id":[{"id":"10.13039\/501100011576","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2026\/4934"],"award-info":[{"award-number":["2026\/4934"]}],"id":[{"id":"https:\/\/ror.org\/04asck240","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Toxic hepatitis may result from drugs, herbal products, mushroom exposure, or other suspected toxic agents. This study aimed to compare the clinical, laboratory, severity-related, and outcome characteristics of toxic hepatitis according to suspected etiology. Materials and Methods: This retrospective observational study included 175 patients diagnosed with toxic hepatitis between January 2012 and March 2026 at a tertiary referral center with an active liver transplantation program. Patients were categorized into five groups: drug-induced liver injury (DILI) (n = 97), herb-induced liver injury (HILI) (n = 17), mushroom poisoning (n = 24), suspected causative agent exposure (n = 15), and unavailable etiological data (n = 22). Clinical outcomes, laboratory parameters, injury patterns, severity grades, and MELD-Na scores were analyzed. Results: Etiological groups differed significantly in demographic, hematological, biochemical, coagulation, bilirubin, ammonia, MELD-Na, and R-ratio parameters. Mushroom poisoning showed the most pronounced hepatocellular injury profile, with higher median values for AST, ALT, INR, ammonia, MELD-Na, and R ratio: 4856 U\/L, 4996 U\/L, 5.0, 585 \u00b5g\/dL, 30, and 78.3, respectively. Recovery was most frequent in the HILI group (94.1%). In multivariable logistic regression analysis, older age (OR = 1.066, 95% CI: 1.03\u20131.11), lower INR (OR = 0.205, 95% CI: 0.08\u20130.51), and higher albumin level (OR = 4.255, 95% CI: 1.55\u201311.63) were independently associated with recovery. Conclusions: Toxic hepatitis showed distinct clinical and biochemical patterns according to etiology. In this selected tertiary referral-center cohort, mushroom poisoning was associated with pronounced hepatocellular injury and frequent liver transplantation, whereas HILI showed a more favorable short-term course. These findings should be interpreted in light of referral bias and the overrepresentation of severe cases.<\/jats:p>","DOI":"10.3390\/medicina62071290","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:39:11Z","timestamp":1783078751000},"page":"1290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Etiology-Based Comparative Evaluation of Toxic Hepatitis in a Tertiary Referral Cohort: Drug-Induced, Herb-Induced, Mushroom Poisoning, and Other Toxic Exposures"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-3454","authenticated-orcid":false,"given":"Suheda Rumeysa","family":"Osmanlioglu-Dag","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Botany, Faculty of Pharmacy, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-0244","authenticated-orcid":false,"given":"Nurullah","family":"Dag","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6864-7711","authenticated-orcid":false,"given":"Sami","family":"Akbulut","sequence":"additional","affiliation":[{"name":"Department of Surgery and Liver Transplantation, Faculty of Medicine, Inonu University, 44280 Malatya, T\u00fcrkiye"},{"name":"Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhsin Murat Muhip","family":"Harputluoglu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8044-0297","authenticated-orcid":false,"given":"Sezai","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Surgery and Liver Transplantation, Faculty of Medicine, Inonu University, 44280 Malatya, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2019). 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