Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today?
For the pathologist, the diagnosis of drug induced liver injury (DILI) is challenging, because histopathological features mimic all primary hepatic and biliary diseases, lacking changes that are specific for DILI. Therefore, in any patient of suspected DILI who underwent liver biopsy, the pathologis...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-01-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119309135 |
| _version_ | 1819014056166555648 |
|---|---|
| author | Rolf Teschke Christian Frenzel |
| author_facet | Rolf Teschke Christian Frenzel |
| author_sort | Rolf Teschke |
| collection | DOAJ |
| description | For the pathologist, the diagnosis of drug induced liver injury (DILI) is challenging, because histopathological features mimic all primary hepatic and biliary diseases, lacking changes that are specific for DILI. Therefore, in any patient of suspected DILI who underwent liver biopsy, the pathologist will assure the clinician that the observed hepatic changes are compatible with DILI, but this information is less helpful due to lack of specificity. Rather, the pathologist should assess liver biopsies blindly, without knowledge of prior treatment by drugs. This will result in a detailed description of the histological findings, associated with suggestions for potential causes of these hepatic changes. Then, it is up to the physician to reassess carefully the differential diagnoses, if not done before. At present, liver histology is of little impact establishing the diagnosis of DILI with the required degree of certainty, and this shortcoming also applies to herb induced liver injury (HILI). To reach at the correct diagnoses of DILI and HILI, clinical and structured causality assessments are therefore better approaches than liver histology results obtained through liver biopsy, an invasive procedure with a low complication rate. |
| first_indexed | 2024-12-21T02:09:46Z |
| format | Article |
| id | doaj.art-8be58305d62b40238acf6dba556f715d |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-21T02:09:46Z |
| publishDate | 2014-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-8be58305d62b40238acf6dba556f715d2022-12-21T19:19:24ZengElsevierAnnals of Hepatology1665-26812014-01-01131121126Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today?Rolf Teschke0Christian Frenzel1Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Academic Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt/ Main, Germany; Correspondence and reprint request:Department of Medicine I, University Medical Center Hamburg Eppendorf, GermanyFor the pathologist, the diagnosis of drug induced liver injury (DILI) is challenging, because histopathological features mimic all primary hepatic and biliary diseases, lacking changes that are specific for DILI. Therefore, in any patient of suspected DILI who underwent liver biopsy, the pathologist will assure the clinician that the observed hepatic changes are compatible with DILI, but this information is less helpful due to lack of specificity. Rather, the pathologist should assess liver biopsies blindly, without knowledge of prior treatment by drugs. This will result in a detailed description of the histological findings, associated with suggestions for potential causes of these hepatic changes. Then, it is up to the physician to reassess carefully the differential diagnoses, if not done before. At present, liver histology is of little impact establishing the diagnosis of DILI with the required degree of certainty, and this shortcoming also applies to herb induced liver injury (HILI). To reach at the correct diagnoses of DILI and HILI, clinical and structured causality assessments are therefore better approaches than liver histology results obtained through liver biopsy, an invasive procedure with a low complication rate.http://www.sciencedirect.com/science/article/pii/S1665268119309135Drug induced liver injuryDrug hepatotoxicityHerb induced liver injuryLiver biopsyLiver histology |
| spellingShingle | Rolf Teschke Christian Frenzel Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today? Annals of Hepatology Drug induced liver injury Drug hepatotoxicity Herb induced liver injury Liver biopsy Liver histology |
| title | Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today? |
| title_full | Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today? |
| title_fullStr | Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today? |
| title_full_unstemmed | Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today? |
| title_short | Drug induced liver injury: do we still need a routine liver biopsy for diagnosis today? |
| title_sort | drug induced liver injury do we still need a routine liver biopsy for diagnosis today |
| topic | Drug induced liver injury Drug hepatotoxicity Herb induced liver injury Liver biopsy Liver histology |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119309135 |
| work_keys_str_mv | AT rolfteschke druginducedliverinjurydowestillneedaroutineliverbiopsyfordiagnosistoday AT christianfrenzel druginducedliverinjurydowestillneedaroutineliverbiopsyfordiagnosistoday |