Drug-induced steatohepatitis.
Drugs rarely cause steatohepatitis, but amiodarone, perhexiline, and DH, have unequivocally been found to independently induce the histologic picture of alcoholic liver disease or NASH. All three agents have similar pathogenetic mechanisms of hepatotoxicity, targeting mitochondrial ATP production and fatty acid catabolism. Other drugs that occasionally cause steatohepatitis, most importantly steroid hormones, likely exacerbate the pathogenetic mechanisms leading to NASH. Similar to NASH, lipid peroxidation resulting from mitochondrial injury may account for all of the histologic findings in drug-induced steatohepatitis. Further research should determine the mechanisms by which drug-induced steatosis, a benign lesion, evolves to steatohepatitis and progressive fibrosis.
Stravitz
R Todd
RT
Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, 1200 East Broad Street, Room 1496, Richmond, VA 23298, USA. rstravit@hsc.vcu.edu
Sanyal
Arun J
AJ
D000638:Amiodarone / Q000009:adverse effects; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D005234:Fatty Liver / Q000139:chemically induced*; D006589:Hexestrol / Q000009:adverse effects; D006801:Humans; D010480:Perhexiline / Q000009:adverse effects
D000889:Anti-Arrhythmia Agents; D018931:Antineoplastic Agents, Hormonal; D002121:Calcium Channel Blockers; D006589:Hexestrol; D010480:Perhexiline; D000638:Amiodarone