The clinical features of drug-induced liver injury observed through liver biopsy: focus on relevancy to autoimmune hepatitis
Clinical and Molecular Hepatology
; : 213-218, 2012.
Article
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| ID: wpr-101276
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ABSTRACT
BACKGROUND/AIMS:
Accurate diagnosis of drug-induced liver injury (DILI) is difficult without considering the possibility of underlying diseases, especially autoimmune hepatitis (AIH). We investigated the clinical patterns in patients with a history of medication, liver-function abnormalities, and in whom liver biopsy was conducted, focusing on accompaniment by AIH.METHODS:
The clinical, serologic, and histologic findings of 29 patients were compared and analyzed. The patients were aged 46.2+/-12.8 years (mean+/-SD), and 72.4% of patient were female. The most common symptom and causal drug were jaundice (58.6%) and herbal medications (55.2%), respectively.RESULTS:
Aspartate aminotransferase (AST), alanine aminotransferase, total bilirubin, alkaline phosphatase, and gamma-glutamyl transpeptidase levels were 662.2+/-574.8 U/L, 905.4+/-794.9 U/L, 12.9+/-10.8 mg/dL, 195.8+/-123.3 U/L, and 255.3+/-280.8 U/L, respectively. According to serologic and histologic findings, 21 cases were diagnosed with DILI and 8 with AIH. The AIH group exhibited significantly higher AST levels (537.1+/-519.1 vs. 1043.3+/-600.5 U/L), globulin levels (2.7+/-0.4 vs. 3.3+/-0.5 g/dL), and prothrombin time (12.9+/-2.4 vs. 15.2+/-3.9 s; P<0.05). Antinuclear antibody was positive in 7 of 21 cases of DILI and all 8 cases of AIH (P=0.002). The simplified AIH score was 3.7+/-0.9 in the DILI group and 6.5+/-0.9 in the AIH group (P<0.001).CONCLUSIONS:
Accurate diagnosis is necessary for patients with a history of medication and visits for liver-function abnormalities; in particular, the possibility of AIH should be considered.
Texte intégral:
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Indice:
WPRIM
Sujet Principal:
Temps de prothrombine
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Aspartate aminotransferases
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Biopsie
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Anticorps antinucléaires
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Hépatite auto-immune
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Science des plantes médicinales
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Alanine transaminase
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Lésions hépatiques dues aux substances
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Globulines
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Ictère
Limites du sujet:
Adult
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Female
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Humans
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Male
langue:
En
Texte intégral:
Clinical and Molecular Hepatology
Année:
2012
Type:
Article