Drug-induced liver disease - A review of 14 cases

C. K. Wang, J. D. Liu, S. Y. Lin, L. Y. Liao, N. Y. Cheng, C. S. Wang, C. P. Siauw, P. H. Chen

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Abstract

The clinical and pathological features of 14 cases of acute drug-induced liver disease (DILD) were analyzed using the French group method for drug reaction assessment. Among them, 8 were of the cytotoxic type, 4 were of the cholestatic type and 2 were of the mixed type. Serum alkaline phosphatase (ALP) levels of the cytotoxic type DILD were all <1.8 times the normal value, while those of the cholestatic type DILD > 1.8 times (P < 0.05). The alanine aminotransaminase and aspartate aminotransaminase (ALT and AST) levels of the cholestatic type were all <13.1 times the normal value, while those of the cytotoxic type varied from 2.2 to 118 times the normal value. We found that steatosis was the major feature in the cytotoxic type with ALT and AST < 2.5 times the normal value. Piecemeal necrosis was noted only in all the cases with ALT and AST > 20 times the normal value. In the cholestatic type, the pathological features of the oral contraceptive-related DILD showed mainly cholestasis, whereas chlorpromazine-related DILD revealed additional portal inflammation. Meticulous taking of patient history and clinical assessment are mandatory for the diagnosis of DILD. The ALP levels were helpful in distinguishing different types of DILD. There are some correlations between biochemical changes and pathological features, and both are helpful in distinguishing different etiologies of DILD when the inciting drug is in doubt.

Original languageEnglish
Pages (from-to)213-219
Number of pages7
JournalKaohsiung Journal of Medical Sciences
Volume11
Issue number4
Publication statusPublished - 1995
Externally publishedYes

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Keywords

  • cholestatic type
  • cytotoxic type
  • drug-induced liver disease

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wang, C. K., Liu, J. D., Lin, S. Y., Liao, L. Y., Cheng, N. Y., Wang, C. S., Siauw, C. P., & Chen, P. H. (1995). Drug-induced liver disease - A review of 14 cases. Kaohsiung Journal of Medical Sciences, 11(4), 213-219.