High doses of salicylates can cause hepatic injury. The onset of injury characteristically occurs after several months of treatment. The majority of cases occur in patients with connective tissue disorders. There usually are no symptoms, simply an increase in serum levels of hepatic transam-inases, but some patients note right upper quadrant abdominal discomfort and tenderness. Overt jaundice is uncommon. The injury usually is reversible upon discontinuation of salicylates. The use of salicylates is contraindicated in patients with chronic liver disease. Salicylates are associated with the severe hepatic injury and encephalopathy observed in Reye's syndrome.
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