The clinical and histological characteristics and outcomes of drug induced chronic liver injury after removing causative drugs.
OBJECTIVE
To investigate characteristics and outcomes of drug induced chronic liver injury after removing causative drugs.


METHODS
Between Apr 2001 and Mar 2010, patients diagnosed as drug induced liver injury and with chronic courses, were observed. Chronic liver injury was defined as persistent biochemical abnormality for more than 6 months after drugs withdrawal.


RESULTS
Forty patients were observed with mean age 41 years and female 28 (70%). Of the 40 patients, 32 (80%) cases showed hepatocellular injury at the onset of liver damage, 4 (10%) cases showed cholestatic injury, and 4 (10%) cases showed mixed injury. Of 32 patients with hepatocellular injury, 24 (75%) cases resemble acute icteric hepatitis at the onset of liver damage. Of 27 patients with hepatocellular injury who underwent liver biopsy, 14 (51.9%) cases showed chronic hepatitis with a mean follow up of 17 months. Of total 40 patients, 15 (37.5%) patients resolved; 18 (45%) cases remained persistent liver injury, 4 (10%) cases developed cirrhosis, 3 (7.5%) cases died. Herbs (45.5%) are the commonest drugs implicated in chronic liver injury.


CONCLUSIONS
Most cases with drug induced chronic liver injury after removing causative drugs resemble acute icteric hepatitis at the onset of liver damage. Some patients can resolve, some may progress to cirrhosis. Herbs are important drugs for drug induced chronic liver injury.
Hou
Feng-Qin
FQ
Department of Infectious Diseases & Center for Liver Diseases, Peking University First Hospital, Beijing 100034, China.
Wang
Tai-Ling
TL
Liu
Xia
X
Huo
Na
N
Wang
Gui-Qiang
GQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D056487:Chemical and Drug Induced Liver Injury, Chronic / Q000188:drug therapy / Q000473:pathology*; D002779:Cholestasis / Q000139:chemically induced; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055815:Young Adult