中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 7
Jul.  2023
Turn off MathJax
Article Contents

Clinical and pathological features of drug-induced liver injury with different types of bile duct injury: An analysis of four cases

DOI: 10.3969/j.issn.1001-5256.2023.07.021
Research funding:

Medical Science Research Project of Hebei Province (20221688)

More Information
  • Corresponding author: WANG Chongkui, sjzwck@163.com (ORCID: 0000-0002-3040-8600)
  • Received Date: 2022-10-24
  • Accepted Date: 2022-11-30
  • Published Date: 2023-07-20
  •   Objective  To investigate the clinical, biochemical, pathological, disease course, and prognostic features of drug-induced liver injury (DILI) patients with different types of bile duct injury.  Methods  Four patients who were diagnosed with bile duct injury-type DILI by liver biopsy in Shijiazhuang Fifth Hospital, from March 2015 to October 2010 were selected, and related data were collected, including clinical data, laboratory examinations, radiological examination, and prognosis.The semi-quantitative score was determined for liver pathological morphology, and each indicator was compared between the four patients.  Results  Bile duct injury-type DILI was more common in female patients, and most patients tended to have a good prognosis.Clinical symptoms, liver biochemical parameters, and prognosis varied with the site, grade, scope, regeneration, and repair of bile duct injury.  Conclusion  Liver biopsy is still the gold standard for making a definite diagnosis of bile duct injury-type DILI, understanding the condition of lesions, and judging the prognosis of this disease.

     

  • loading
  • [1]
    LAI RT, YU YC, CHEN CW. Review and clinical concerns of drug-induced liver injury in 2021[J]. Chin Hepatol, 2022, 27(1): 1-3. DOI: 10.3969/j.issn.1008-1704.2022.01.001.

    赖荣陶, 于乐成, 陈成伟. 2021药物性肝损伤研究回顾和临床关注的问题[J]. 肝脏, 2022, 27(1): 1-3. DOI: 10.3969/j.issn.1008-1704.2022.01.001.
    [2]
    KLEINER DE, CHALASANI NP, LEE WM, et al. Hepatic histological findings in suspected drug-induced liver injury: Systematic evaluation and clinical associations[J]. Hepatology, 2014, 59(2): 661-670. DOI: 10.1002/hep.26709.
    [3]
    LEWIS JH, KLEINER DE. Hepatic injury due to drugs, herbal compounds, chemicals and toxins[M]// MacSween's Pathology of the Liver, 6th ed. Edinburgh: Churchill Livingstone, 2014: 654-655.
    [4]
    Drug-induced Liver Disease Study Group, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the management of drug-induced liver injury[J]. J Clin Hepatol, 2015, 31(11): 1752-1769. DOI: 10.3969/j.issn.1001-5256.2015.11.002.

    中华医学会肝病学分会药物性肝病学组. 药物性肝损伤诊治指南[J]. 临床肝胆病杂志, 2015, 31(11): 1752-1769. DOI: 10.3969/j.issn.1001-5256.2015.11.002.
    [5]
    Drug-induced Liver Disease Study Group, Chinese Society of Hepatology, Chinese Medical Association. Interpretation of CSH clinical guideline: The diagnosis and management of drug-induced liver injury[M]. Shanghai: Shanghai Scientific & Technical Publishers, 2015.

    中华医学会肝脏病学分会药物性肝病学组. 药物性肝损伤诊治指南解读[M]. 上海: 上海科学技术出版社, 2015.
    [6]
    VUPPALANCHI R, CHALASANI N, SAXENA R. Restoration of bile ducts in drug-induced vanishing bile duct syndrome due to zonisamide[J]. Am J Surg Pathol, 2006, 30(12): 1619-1623. DOI: 10.1097/01.pas.0000213342.78475.48.
    [7]
    YANG Y, GE FL, HUANG Q, et al. Risk factors for herb-induced liver injury[J]. J Clin Hepatol, 2022, 38(5): 1183-1187. DOI: 10.3969/j.issn.1001-5256.2022.05.044.

    杨燕, 葛斐林, 黄倩, 等. 中药相关肝损伤的风险因素[J]. 临床肝胆病杂志, 2022, 38(5): 1183-1187. DOI: 10.3969/j.issn.1001-5256.2022.05.044.
    [8]
    WANG HZ, LI XH. Research advances in the pathogenesis of drug-induced liver injury[J]. J Clin Hepatol, 2018, 34(4): 883-887. DOI: 10.3969/j.issn.1001-5256.2018.04.040.

    王海珍, 李秀惠. 药物性肝损伤发病机制研究进展[J]. 临床肝胆病杂志, 2018, 34(4): 883-887. DOI: 10.3969/j.issn.1001-5256.2018.04.040.
    [9]
    WANG TL, ZHAO XY, SHAO C, et al. A proposed pathologic sub-classification of drug-induced liver injury[J]. Hepatol Int, 2019, 13(3): 339-351. DOI: 10.1007/s12072-019-09940-9.
    [10]
    WASUWANICH P, CHOUDRY H, SO JM, et al. Vanishing bile duct syndrome after drug-induced liver injury[J]. Clin Res Hepatol Gastroenterol, 2022, 46(9): 102015. DOI: 10.1016/j.clinre.2022.102015.
    [11]
    BELL LN, CHALASANI N. Epidemiology of idiosyncratic drug-induced liver injury[J]. Semin Liver Dis, 2009, 29(4): 337-347. DOI: 10.1055/s-0029-1240002.
    [12]
    MEDINA-CALIZ I, ROBLES-DIAZ M, GARCIA-MUÑOZ B, et al. Definition and risk factors for chronicity following acute idiosyncratic drug-induced liver injury[J]. J Hepatol, 2016, 65(3): 532-542. DOI: 10.1016/j.jhep.2016.05.003.
    [13]
    de VRIES E, BEUERS U. Management of cholestatic disease in 2017[J]. Liver Int, 2017, 37(Suppl 1): 123-129. DOI: 10.1111/liv.13306.
    [14]
    WU WX, WANG T, GENG XC, et al. Progress in study of drug-induced cholestasis liver injury[J]. Chin J New Drugs, 2020, 29(2): 143-151. DOI: 10.3969/j.issn.1003-3734.2020.02.005.

    吴文晓, 王婷, 耿兴超, 等. 药物性胆汁淤积型肝损伤的研究进展[J]. 中国新药杂志, 2020, 29(2): 143-151. DOI: 10.3969/j.issn.1003-3734.2020.02.005.
    [15]
    MANCO R, CLERBAUX LA, VERHULST S, et al. Reactive cholangiocytes differentiate into proliferative hepatocytes with efficient DNA repair in mice with chronic liver injury[J]. J Hepatol, 2019, 70(6): 1180-1191. DOI: 10.1016/j.jhep.2019.02.003.
    [16]
    ZHU ZW, HUANG HL. Research progress on physiological characteristics of bile duct epithelial cells and their correlation with liver diseases[J]. J Hepatopancreatobiliary Surg, 2022, 34(3): 187-192. DOI: 10.11952/j.issn.1007-1954.2022.03.013.

    朱志文, 黄海丽. 胆管上皮细胞的生理学特点及其与肝脏疾病相关性的研究进展[J]. 肝胆胰外科杂志, 2022, 34(3): 187-192. DOI: 10.11952/j.issn.1007-1954.2022.03.013.
    [17]
    CHEUNG AC, LORENZO PISARELLO MJ, LARUSSO NF. Pathobiology of biliary epithelia[J]. Biochim Biophys Acta BBA Mol Basis Dis, 2018, 1864(4): 1220-1231. DOI: 10.1016/j.bbadis.2017.06.024.
    [18]
    RAVEN A, LU WY, MAN TY, et al. Cholangiocytes act as facultative liver stem cells during impaired hepatocyte regeneration[J]. Nature, 2017, 547(7663): 350-354. DOI: 10.1038/nature23015.
    [19]
    CHALASANI NP, HAYASHI PH, BONKOVSKY HL, et al. ACG Clinical Guideline: The diagnosis and management of idiosyncratic drug-induced liver injury[J]. Am J Gastroenterol, 2014, 109(7): 950-966; quiz967. DOI: 10.1038/ajg.2014.131.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(4)  / Tables(5)

    Article Metrics

    Article views (368) PDF downloads(61) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return