Drug and Toxin-Induced
Liver disease
Epidemiology:
Common sites:
Gross features:
Histologic features:
- Can have many
patterns of injury
- Zonal areas of
necrosis is suggestive of toxin
- Microvesicular steatosis:
- Tetracycline, salicylates, yellow phosphorous, ethanol
- Macrovesicular steatosis:
- Ethanol, methotrexate, amiodarone
- Centrilobular necrosis:
- Bromobenzene, CCl4, acetaminophen, halothane, rifampin
- Diffuse or massive
necrosis:
- Halothane, isoniazid, acetaminophen, methyldopa, trinitoluene, Amanita
phalloides (mushroom)
- Hepatitis, acute
and chronic:
- Methyldopa, isoniazid, nitrofurantoin,
phenytoin, oxyphenisatin
- Fibrosis-cirrhosis:
- Ethanol, methotrexate, amiodarone, most
drugs that cause chronic hepatitis
- Granuloma formation:
- Sulfonamides,
methyldopa, quinidine, phenylbutazone,
hydralazine, allopurinol
- Cholestasis (with or without hepatocellular
injury):
- Chlorpromazine, anabolic
steroids, erythromycin, estolate, oral
contraceptives, organic arsenicals
- Acetaminophen:
- Injury around
central vein
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
References: