Efficacy of N-acetylcysteine With or Without Steroids in Drug Induced Liver Injury
Efficacy of N-acetylcysteine With or Without Steroids in Drug Induced Liver Injury
Intervention - Subjects will be randomized to 2 groups

 Group A - subjects will receive Prednisolone for 20 days with NAC (N-Acetylcysteine)

 Group B - will receive NAC (N-Acetylcysteine) only NAC (N-acetylcysteine) dosing

 Loading dose: 150 mg/kg IV; mix in 200 mL of 5% dextrose in water (D5W) and infuse over 1
 hour

 Dose 2: 50 mg/kg IV in 500 mL D5W over 4 h

 Dose 3: 100 mg/kg IV in 1000 mL D5W over 16 h

 -  Monitoring and assessment-Liver Biopsy at baseline and at 3 months, Liver Function Test
 at regular intervals.

 -  Stopping rule-Development of sepsis, worsening of Liver functions.
Inclusion Criteria:

 -  All patients with severe DILI (Drug Induced Liver Injury)

 -  Age more than or equal to 18 years

 Exclusion Criteria:

 -  Patients with HAV (Hepatitis A Virus), HBV (Hepatitis B Virus), HCV (Hepatitis C
 Virus), HEV (Hepatitis E Virus) Positive

 -  Patients with sepsis

 -  AMA positive

 -  Low Ceruloplasmin

 -  Transferrin saturation >45%

 -  Patients with Cirrhosis

 -  Patients with h/o jaundice prior to the intake of drug