Kasper H-U, Drebber U, Hirsch I, Dienes H P
Institut für Pathologie am Clemenshospital, Medical-Center-Düesbergweg 128, 48153, Münster, and Institut für Pathologie, Universität zu Köln, Germany.
Pathologe. 2006 May;27(3):175-81. doi: 10.1007/s00292-006-0826-1.
Hepatotoxicity is a significant complication of therapeutic drug use. As ist can imitate nearly all hepatopathies, the diagnosis of drug-induced liver disease is difficult. Most often, it is a diagnosis of exclusion. The following morphological changes are known, dependent on the target cell type: acute and chronic hepatitis, granuloma formation, and fatty liver disease, cholestatic type acute and chronic liver damage with or without inflammation,or mixed forms of liver injury. Portal or perisinusoidal fibrosis can occur following each type of liver damage. Vascular changes or neoplasms are rare. Drug induced liver injuries are more likely induced by type B damage, which is not expected and cannot be reproduced in animal testing. Type A damage, which is known from toxicity assays, is less likely. A specific therapeutic regime is not available. Therefore, early recognition and cessation of the use of the drug is necessary.
肝毒性是治疗性药物使用的一种重要并发症。由于它几乎可以模仿所有肝病，药物性肝病的诊断很困难。大多数情况下，这是一种排除性诊断。根据靶细胞类型，已知以下形态学变化：急性和慢性肝炎、肉芽肿形成、脂肪性肝病、胆汁淤积型急性和慢性肝损伤（伴有或不伴有炎症），或混合性肝损伤。每种类型的肝损伤后都可能发生门脉或窦周纤维化。血管变化或肿瘤很少见。药物性肝损伤更可能由B型损伤引起，这种损伤在动物试验中无法预期且无法重现。从毒性试验中已知的A型损伤则不太可能。目前没有特定的治疗方案。因此，早期识别并停止使用该药物是必要的。
