DrugInduced Liver Disease Patterns of Injury

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Drug-Induced Liver DiseasePatterns of Injury

• Acute
• Hepatocellular
• Cholestatic
• Mixed
• Vascular

• Chronic
• Hepatocellular
• Cholestatic
• Granulomas
• Fibrosis/cirrhosis
• Vascular
• Neoplasms

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Drug-Induced Liver DiseasePatterns of Injury -
Examples

• Tetracycline
• Microvesicular fat
• Chronic cholestasis (rare)
• Chronic hepatitis (minocycline)
• Amoxicillin-Clavulanate
• Cholestasis ? cholangitis, hepatocellular
• injury, granulomas
• Nitrofurantoin - incidence approx. 1/3000
• Acute hepatitis - 30
• Chronic hepatitis - 50
• Cholestasis - 10

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Drug-Induced Liver DiseaseSuspect

• Always
• Atypical Patterns
• Cholestatic hepatitis
• Granulomatous hepatitis
• Hepatitis eosinophils
• Zonal necrosis
• Severe acute hepatitis

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