Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Administration of etretinate in a 29-year-old female patient suffering from severe pustular psoriasis caused a dramatic increase in liver enzymes. Liver biopsy revealed changes characteristic for drug-induced hepatitis. After normalization of liver parameters following withdrawal of etretinate, isotretinoin was administered during a severe pustular relapse. In contrast to etretinate, isotretinoin was well tolerated and resulted in a good therapeutic response. Thus, isotretinoin can be considered as an effective and safe therapeutic alternative for pustular psoriasis even after the occurrence of etretinate-induced hepatitis.
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PMID:[Successful use of isotretinoin in type Zumbusch generalized pustular psoriasis following recovered etretinate-induced hepatitis]. 193 11

Two fatal cases of amiodarone-induced acute, confluent, necrotic hepatitis are described. The patients, aged 28 and 60, had received a high loading dose of amiodarone. After the first and second day respectively following the administration of amiodarone, the patients developed jaundice, hepatomegaly, high serum transaminases, a prolonged prothrombin time and low cholesterol concentration. They died of hepatic coma and acute renal failure on the fourteenth and fourth day respectively. Needle liver biopsy, performed immediately after death, revealed lesions of acute drug-induced hepatitis with confluent and bridging necrosis. It is proposed that rapid administration of a high loading dose of amiodarone can cause acute confluent necrotic hepatitis. The mode of administration and the dosage of the drug should be re-considered.
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PMID:Acute amiodarone-induced hepatitis. 202 92

A thorough clinicomorphologic examination of 288 pulmonary tuberculosis patients with hepatic dysfunction revealed drug-induced hepatitis in 16.3% of the cases during their chemotherapy. Drug-induced hepatitis was found to be acute in 29.7%, chronic active in 27.6% and chronic persistent in 42.7% of these patients. Life-time morphologic investigation of the liver biopsy specimens is of primary importance for the evaluation of hepatitis etiology and its progress. The most characteristic morphologic features of drug-induced hepatitis are the presence of eosinophilic leukocytes in lymphomacrophagal inflammatory infiltrates, hyperplasia of smooth cytoplasmic network of hepatocytes and gigantic mitochondria with paracrystals in the matrix, fatty degeneration of hepatic cells as well as the presence of stellate reticuloendotheliocytes with abundant heterogeneous inclusions.
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PMID:[Clinical-morphological criteria of drug-induced hepatitis in pulmonary tuberculosis patients]. 203 16

An attachment of lymphocytes to the vascular wall, a feature called "endothelialitis" (ETL) or "endotheliitis", was investigated in various liver biopsies, including acute hepatitis (AH), hepatic infectious mononucleosis (IM), drug-induced hepatitis, alcoholic hepatitis and fibrosis, chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), liver cirrhosis (LC), primary biliary cirrhosis (PBC), nonspecific reactive hepatitis (NSRH), and cases with a variety of diseases having almost normal liver histology as control material. Although ETL has been considered to be nearly pathognomic of graft-versus-host disease (GVHD) and acute transplant rejection, ETL was found in both portal and central veins with a variable incidence, not only in all categories of liver diseases, but also in the control group. The incidence of central vein ETL was significantly higher in AH, CAH, PBC, IM, alcoholic fibrosis, and NSRH than that of the control group, and that of portal vein ETL was significantly higher in AH, CPH, CAH, LC, PBC, IM, and alcoholic fibrosis. Even under the light microscope, lymphocytes attached to the endothelial cells had irregular cytoplasmic processes making contact with endothelial cells. Also lymphocytes located beneath the endothelial lining were frequently found. When ETL-positive and -negative cases in the same category were compared, the levels of serum glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) were usually higher in the ETL-positive group, and statistically significant differences were observed in CPH, CAH, LC, PBC and NSRH. In chronic hepatitis, the occurrence of portal vein ETL paralleled the histologic activity of portal inflammation, whereas central vein endothelialitis was associated with active parenchymal inflammation such as sinusoidal lymphocyte infiltration and spotty hepatocyte necrosis, indicating that ETL may be a phenomenon more frequently associated with active hepatic inflammation. Immunohistochemical observations revealed that about 70% of lymphocytes attached to the endothelial cells were T cells, while about 10% were B cells. These data indicate that ETL in the liver is not specifically pathognomonic for GVHD and rejection of liver transplants, and is universally found in a variety of liver diseases with a varying incidence and activity, related to the activity of hepatic inflammation, portal vein ETL occurring in relation to active portal inflammation and central vein ETL to parenchymal inflammation. Thus ETL is considered to be an intimate T lymphocyte-endothelial cell interaction universally associated with active hepatic inflammation; it may be an important phenomenon leading to accumulation of cellular exudates and their reaction at the site of antigen in the tissue.
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PMID:Clinicopathological study of lymphocyte attachment to endothelial cells (endothelialitis) in various liver diseases. 205 5

An overview about drug-induced liver injury is presented. The most frequent changes of the hepatocytes are those of the organelles, which are adaptive at the beginning, but in later stages they can develop to degenerative alterations leading to necrosis. Cases of drug-induced hepatitis simulating all types of non-suppurative hepatitis are a major problem of diagnosis. Bile duct lesions can include pure cholestasis, cholangiolitis and destruction of intrahepatic ducts. Drug-induced vascular lesions including tumours can be found as isolated phenomenon or in association with other signs of drug-induced liver damage. Hyperplasia (focal or diffuse) and neoplasia of the liver can develop in the course of a longstanding application of some drugs.
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PMID:[Drug-induced liver damage from the morphologic viewpoint]. 220 23

We report a 3-week-old boy with cholestatic hepatitis, most likely due to carbamazepine exposure during pregnancy and breastfeeding. Cholestasis resolved after cessation of nursing. Liver function test results and histological findings were compatible with a drug-induced hepatitis. Other causes were excluded. While carbamazepine-induced hepatitis is well known in children and adults, it has never been described in association with prenatal exposure and/or breast-feeding.
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PMID:Transient cholestatic hepatitis in a neonate associated with carbamazepine exposure during pregnancy and breast-feeding. 227 11

In a survey of patients admitted to the medical and surgical wards of Groote Schuur Hospital during the 5-year period 1983-1987 38 patients with severe drug-induced hepatitis were identified. Fifty-three per cent of these reactions were caused by anti-tuberculosis drugs, 21% to phenytoin and 11% to methyldopa. Whereas 82% of the patients were jaundiced, only one-third had gastro-intestinal symptoms and/or fever and only 24% had a rash. Twenty-six per cent of patients were encephalopathic on admission. The overall mortality rate was 24%. Forty per cent of patients with hepatitis caused by anti-tuberculosis therapy died. Many patients had continued to receive therapy despite signs of liver disease. These findings underline the need for a high index of suspicion in the diagnosis of drug-induced liver disease and for early withdrawal of the offending agent(s).
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PMID:Retrospective survey of drug-induced liver disease at Groote Schuur Hospital, Cape Town--1983-1987. 230 Aug 55

70 cases of acute dihydralazine-associated hepatitis with centrolobular or confluent necroses, registered in the files of the Berlin-Friedrichshain Institute of Pathology, between 1981 and 1985, were classified into 3 types of diagnostic probability for differential diagnosis versus virus hepatitis. Classification was conducted according to recommendations given by a working group of pathologists, specialised in liver pathology. 42 cases out of this material had come from Prenzlauer-Berg Hospital, Department of Infectious Diseases, and were re-examined under clinical aspects. 6 of them were discarded from evaluation. Type I proved to be of high diagnostic reliability, as was seen from 61% of all cases. Only 3 cases had to be discarded from that group and were associated with other drugs, such as halothane, methyldopa, and propranolol. The following clinical parameters proved to be of particular value for definite assessment of drug-induced hepatitis: time of exposure (for analysis of co-medication), time of recovery, and re-exposure test. Only circumstantial evidence so far can be provided for all histological types to causative relationship between drug ingestion and hepatitis. Compliance with mandatory notification should be ensured in all cases, since suspicious cases are explicitly included. Higher sex-related disposition of women to drug-induced hepatitis was confirmed in our material, with the female-to-male ratio being 3:1.
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PMID:[Dihydralazine hepatitis. Morphologic and clinical criteria for diagnosis]. 232 83

Sera from patients with dihydralazine-induced hepatitis were shown to contain anti-liver microsomal autoantibodies (anti-LM) by indirect immunofluorescence. These anti-LM antibodies were different from anti-liver/kidney microsomes (anti-LKM) 1 or 2 autoantibodies which have been previously described. Sera recognized a single 53,000 = Mr polypeptide in human liver microsomes as judged by immunoblotting, and the target antigen was identified as cytochrome P-450IA2 (P-450IA2) by (a) comparison of immunoblotting patterns with anti-human P-450IA2 and anti-rat P-450IA2 and with five anti-LM sera, and (b) specific immunoinhibition of microsomal ethoxyresorufin and phenacetin O-deethylation activities (both P-450IA2 supported reactions) by anti-LM antibodies. Finally, purified human P-450IA2 was recognized by these anti-LM sera. The anti-LM antibodies are specific for the disease because none of the other antisera tested behaved in the same manner as anti-LM, even those from patients treated with dihydralazine and without hepatic disease. A possible role of P-450IA2 in the metabolism of dihydralazine was suggested by competitive inhibition of ethoxyresorufin-O-deethylase observed in microsomal incubations. Thus, a new example is presented in which a cytochrome P-450 may be a target for autoantibodies in drug-induced hepatitis.
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PMID:Anti-liver endoplasmic reticulum autoantibodies are directed against human cytochrome P-450IA2. A specific marker of dihydralazine-induced hepatitis. 234 20

Between April 1976 and March 1987, in an Internal Medicine department some 300 unguided percutaneous liver biopsies were performed, using the Tru-Cut excision needle. The procedure contributed to the diagnosis in 76.2% of the cases. In alcoholism-related pathology with its specific lesions, liver biopsy is particularly useful in diagnosing incipient fatty degeneration and hepatitis and helps in the prognosis of cirrhosis. In chronic hepatitis, it asserts the diagnosis and provides aetiological and prognostic data. The finding of granulomas at histology sometimes clinches a hitherto undecided diagnosis : sarcoidosis or tuberculosis? The diagnosis of drug-induced hepatitis rests on convergent clinical, biochemical and histological elements. In blood diseases, liver biopsy is of interest on three scores: it shows whether or not the liver is involved, detects intercurrent complications and evaluates the extent of the lesions before treatment. When performed after ultrasonography, it enables intrahepatic cholestasis to be recognized and extrahepatic cholestasis, unidentified by ultrasounds, to be suspected. In primary biliary cirrhosis, it confirms the diagnosis and informs on the severity and progressiveness of the disease. In hepatic cancers, liver biopsy has recently been superseded by computerized tomography and ultrasonography. Finally, it largely contributes to the diagnosis of overload disease and evaluates their activity and their impact on the liver.
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PMID:[Value of liver biopsy in internal medicine. Apropos of a series of 300 puncture biopsies]. 239 71


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