1.Department of Medical Service; 3. Department of Hepatological Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China; 2. Liver Disease Department,Hebei Hospital of Traditional Chinese Medicine for Liver Disease,Hebei 050800,China; 4. Department of Integrative Medicine,the Fifth Medical Center,Chinese PLA General Hospital,Beijing 100039,China
AbstractObjective To explore the clinical features of drug-induced liver injury(DILI) in patients diagnosed by liver biopsy.Methods A retrospective study was conducted of 179 patients treated at the Fifth Medical Center of Chinese PLA General Hospital between January 2010 and January 2015. All of them had abnormal liver function and were diagnosed with drug-induced liver injuries by liver biopsy that were caused by factors other than common liver disease, including hepatitis A, B, C, E, virus EB, CMV virus infection, autoimmunity liver disease, alcoholic liver disease, nonalcoholic fatty hepatopathy and genetic metabolic liver disease. These patients were assigned to two groups according to liver biopsy results to analyze clinical features and results of biopsy.Results The acute/subacute group consisted of mainly young patients(64.3%), while in the chronic group, elder patients accounted for 53.7%(P＜0.05). In terms of clinical manifestations, such as fatigue, liver discomfort, fever and skin pruritus, there was no difference between those two groups (P＞0.05).Poor appetite(50.0％ vs 30.9％) and dark urine(58.9％ vs 30.5％) were much more common in the acute/sub-acute group than in the chronic group(P＜0.05). In terms of biochemical detection of liver function, levels of ALT, AST, TBIL and DBIL were significantly higher in the acute/sub-acute group than in the chronic group (P＜0.01), but there was no obvious difference in terms of ALP, GGT or ANA. There was no difference in manifestations of cholestasis biopsy between the two groups. The acute/subacute group had more biopsy manifestations of the mixed type while the chronic liver injury group had more cases of hepatocellular injury.Conclusions The seniors are vulnerable to chronic drug-induced liver injuries, especially i hepatocellular injuries. Patients with recurring and hepatic dysfunction for unknown reasons must be alert to potential chronic drug-induced liver injuries.
XU Jiaojiao,KANG Yanyan,CHEN Yongwei等. Clinical features of abnormal liver function in patients diagnosed with drug-induced liver injury by liver biopsy[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(3): 240-243.
Sumeet K A, Harshad D, John E, et al. Burden of liver diseases in the world[J]. Hepatology, 2019, 70(1):151-157 .
[2]
Chalasani N P, Hayashi P H, Bonkovsky H L, et al. ACG Clinical Guideline: the diagnosis and management of idiosyncratic drug-induced liver injury[J]. Am J Gastroenterol, 2014, 109(7): 950-967.
[3]
Lu R J, Zhang Y, Tang F L, et al. Clinical characteristics of drug-induced liver injury and related risk factors [J]. ExpTher Med, 2016, 12(4): 2606-2616.
[4]
Lee B M, Lee W C, Jang J Y, et al. Clinical features of drug-induced liver injury according to etiology [J]. J Korean MedSci, 2015, 30(12): 1815-1820.
[5]
Aithal G P, Watkins P B, Andrade R J, et al. Case definition and phenotype standardization in drug-induced liver injury[J]. Clin Pharmacol Ther, 2011, 89(6): 806-815.
[6]
Chen Minjun, Bisgin H, Tong Lillian,et al. Toward predictive models for drug induced liver injury in humans:are we there yet [J]. Biomarkers Med,2014,8(2):201-213.
[7]
Kubo S, Matsuzaki K, Sek T, et al.Severe acute hepatitis in a printing company worker: a case study[J]. J Occup Health, 2015,57(1):87-90.
[8]
Davern T J. Drug -induced liver disease [J] . Clin Liver Dis ,2012,16(2):231-245.
2019, Vol. 30 
