medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2014, Number 1

<< Back Next >>

Ann Hepatol 2014; 13 (1)

Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today?

Teschke R, Frenzel C

Language: English
References: 35
Page: 121-126
PDF size: 121.27 Kb.


ABSTRACT

For the pathologist, the diagnosis of drug induced liver injury (DILI) is challenging, because histopathological features mimic all primary hepatic and biliary diseases, lacking changes that are specific for DILI. Therefore, in any patient of suspected DILI who underwent liver biopsy, the pathologist will assure the clinician that the observed hepatic changes are compatible with DILI, but this information is less helpful due to lack of specificity. Rather, the pathologist should assess liver biopsies blindly, without knowledge of prior treatment by drugs. This will result in a detailed description of the histological findings, associated with suggestions for potential causes of these hepatic changes. Then, it is up to the physician to reassess carefully the differential diagnoses, if not done before. At present, liver histology is of little impact establishing the diagnosis of DILI with the required degree of certainty, and this shortcoming also applies to herb induced liver injury (HILI). To reach at the correct diagnoses of DILI and HILI, clinical and structured causality assessments are therefore better approaches than liver histology results obtained through liver biopsy, an invasive procedure with a low complication rate.


REFERENCES

  1. Zimmerman HJ. Hepatotoxicity. Philadelphia: Lippincott Williams & Wilkins; 1999.

  2. Kaplowitz N, DeLeve LD. Drug-Induced Liver Disease. 3rd Ed. Waltham, Mass., USA: Academic Press; 2013.

  3. Teschke R, Frenzel C, Schulze J, Eickhoff A. Herbal hepatotoxicity: challenges and pitfalls of causality assessment methods. World J Gastroenterol 2013; 19: 2864-82.

  4. Teschke R, Frenzel C, Wolff A, Eickhoff A, Schulze J. Drug induced liver injury: Accuracy of diagnosis in published reports. Ann Hepatol 2014; in press.

  5. Teschke R, Schulze J, Schwarzenboeck A, Eickhoff A, Frenzel C. Herbal hepatotoxicity: suspected cases assessed for alternative causes. Eur J Gastroenterol Hepatol 2013; DOI: 10.1097/MEG.0b013e3283603e89.

  6. Aithal GP, Rawlins MD, Day CP. Accuracy of hepatic adverse drug reaction reporting in one English health region. Br Med J 1999; 319: 154.

  7. Ghabril M, Bonkovsky HL, Kum C, Davern T, Hayashi PH, Kleiner DE, Serrano J, et al, U.S. Drug-Induced Liver Injury Network. Liver injury from tumor necrosis factor-α antagonists: analysis of thirty-four cases. Clin Gastroenterol Hepatol 2013; 11: 558-64.

  8. Maria VAJ, Victorino RMM. Development and validation of a clinical scale for the diagnosis of drug-induced hepatitis. Hepatology 1997; 26: 664-9.

  9. Rochon J, Protiva P, Seeff LB, Fontana RJ, Liangpunsakul S, Watkins PB, Davern T, et al., for the Drug-Induced Liver Injury Network (DILIN). Reliability of the Roussel Uclaf Causality Assessment Method for assessing causality in drug-induced liver injury. Hepatology 2008; 48: 1175-83.

  10. Lucena MI, Camargo R, Andrade RJ, Perez-Sanchez CJ, Sanches de la Cuesta F. Comparison of two clinical scales for causality assessment in hepatotoxicity. Hepatology 2001; 33: 123-30.

  11. De Valle MB, AV Klinteberg V, Alem N, Olsson R, Björnsson E. Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic. Aliment Pharmacol Ther 2006; 24: 1187-95.

  12. Schoepfer AM, Engel A, Fattinger K, Marbet UA, Criblez D, Reichen J, Zimmermann A, et al. Herbal does not mean innocuous: ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife products. J Hepatol 2007; 47: 521-6.

  13. Teschke R, Genthner A, Wolff A, Frenzel C, Schulze J, Eickhoff A. Herbal hepatotoxicity: Analysis of cases with initially reported positive reexposure tests. Dig Liv Dis 2014 [In press]. DOI: 10.1016/j.dld.2013.10.020

  14. Elinav E, Pinkser G, Safadi R, Pappo O, Bromberg M, Anis E, Keinan-Boker L, et al. Association between consumption of Herbalife® nutritional supplements and acute hepatotoxicity. J Hepatol 2007; 47: 514-20.

  15. Jung KA, Min HJ, Yoo SS, Kim HJ, Choi SN, Ha CY, Kim HJ, et al. Drug-induced liver injury: Twenty five cases of acute hepatitis following ingestion of Polygonum multiflorum Thun. Gut Liver 2011; 5: 493-9.

  16. Wai CT, Tan BH, Chan CL, Sutedja DS, Lee YM, Khor C, Lim SG. Drug-induced liver injury at an Asian center: a prospective study. Liver Int 2007; 27: 244-54.

  17. Aithal GP, Rawlins MD, Day CP. Clinical diagnostic scale: a useful tool in the evaluation of suspected hepatotoxic adverse drug reactions. J Hepatol 2000; 33: 949-52.

  18. Sgro C, Clinard F, Ouazir K, Chanay H, Allard C, Guilleminet C, Lenoir C, et al. Incidence of drug-induced hepatic injuries: a French population-based study. Hepatology 2002; 36: 451-5.

  19. Björnsson E, Jacobsen EI, Kalaitzakis E. Hepatotoxicity associated with statins: Reports of idiosyncratic liver injury post-marketing. J Hepatol 2012; 56: 374-80.

  20. Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, Yang HQ, et al., for the Drug Induced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology 2008; 135: 1924-34.

  21. Aithal PG, Day CP. The natural history of histologically proved drug induced liver disease. Gut 1999; 44: 731-5.

  22. Andrade RJ, Lucena MI, Kaplowitz N, García-Muñoz B, Borraz Y, Pachkoria K, García-Cortés M, et al. Outcome of acute idiosyncratic drug-induced liver injury: long term follow-up in a hepatotoxicity registry. Hepatology 2006; 44: 1581-8.

  23. Aithal GP, Watkins PB, Andrade RJ, Larrey D, Molokhia M, Takikawa H, Hunt CM, et al. Case definition and phenotype standardization in drug-induced liver injury. Clin Pharmacol Ther 2011; 89: 806-15.

  24. Teschke R, Schwarzenboeck A, Eickhoff A, Frenzel C, Wolff A, Schulze J. Clinical and causality assessment in herbal hepatotoxicity. Expert Opin Drug Saf 2013; 12: 330-66.

  25. Danan G, Bénichou C. Causality assessment of adverse reactions to drugs – I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol 1993; 46: 1323-30.

  26. Teschke R, Eickhoff A, Schulze J. Drug- and herb-induced liver injury in clinical and translational hepatology: Causality assessment methods, quo vadis? J Clin Translat Hepatol 2013; 1: 59-74.

  27. Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment Pharmacol Ther 2013; 37: 3-17.

  28. Teschke R, Frenzel C, Glass X, Schulze J, Eickhoff A. Greater Celandine hepatotoxicity: a clinical review. Ann Hepatol 2012; 11: 838-48.

  29. Teschke R. Kava hepatotoxicity – a clinical review. Ann Hepatol 2010; 9: 251-65.

  30. Ramachandran R, Kakar S. Histological patterns in drug-induced liver disease. J Clin Pathol 2009; 62: 481-92.

  31. Bergesch D’Incao R, Campos Appel da Silva M, Lerias de Almeida PR, Plasse Renon V, Valle Tovo C. Percutaneous liver biopsy – 2 decades of experience in a public hospital in the South of Brazil. Ann Hepatol 2013; 12: 876-80.

  32. Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy: a multicenter retrospective study on 68,276 biopsies. J Hepatol 1986; 2: 165-73.

  33. Teschke R, Frenzel C, Schulze J, Schwarzenboeck A, Eickhoff A. Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests. World J Hepatol 2013; 5: 353-63.

  34. Kleiner DE, Chalasani NP, Lee WM, Fontana RJ, Bonkovsky HL, Watkins PB, Hayashi PH, et al., for the Drug-Induced Liver Injury Network (DILIN). Hepatic histological findings in suspected drug-induced liver injury: Systematic evaluation and clinical associations. Hepatology [In press]. DOI: 10.1002/hep.26709.

  35. Andrade RJ, Lucena MI, Fernández MC, Pelaez G, Pachkoria K, García-Ruiz E, García-Muñoz B, et al., Spanish Group for the Study of Drug-induced Liver Disease. Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Gastroenterology 2005; 129: 512-21.




2020     |     www.medigraphic.com