[Effects of drugs on the liver. A review illustrated with 3 clinical cases].

Eleven hundred cases of drug induced liver disease have been reported in Denmark from 1978 to 1987, including 52 fatal cases. Approximately 100 new cases have been reported every year since 1987. The definition and classification of drug induced liver disease are presented together with a review of the most common patho-anatomical pictures and pathogenetic mechanisms, followed by a description of symptoms and paraclinical abnormalities for each of the ten most common drugs causing serious liver disease. Individual cases of liver disease caused by paracetamol, sulfamethizole and androgenic steroid hormones are presented. Guidelines to minimize the risk of liver disease when using halothane, disulfiram or methotrexate are mentioned. Finally there are some proposals for diminishing the number of and the severity of drug induced liver disease.