Drug-induced hepatitis clinical manifestations and prognosis

Clinical manifestations】 【 The clinical manifestations of liver medicine one drug with the type of liver damage caused liver disease and the different mechanism. According to clinical features of acute and chronic can be divided into two categories. Acute liver cell damage, acute hepatitis most common drugs, mainly to liver cell necrosis, the clinical manifestations of acute viral hepatitis resembles often fever, fatigue, lack of appetite, jaundice and elevated serum transaminase (normal 2 to 30 times), and albumin ALP affected smaller, hyperbilirubinemia and prothrombin time with the Director of the severity of liver damage associated. Less severe diseases, will be restored after stopping short-term (a few weeks to several months), who re-occurrence of liver failure, a progressive jaundice, bleeding tendencies and hepatic encephalopathy, and often death. Consisting mainly of acute allergic reaction to medicine liver, often fever, rash, jaundice, swollen lymph nodes, with serum aminotransferase, bilirubin and ALP moderately higher drug exposure history often shorter (four weeks within). To cholestasis based medicine liver, the clinical and laboratory manifestations and intrahepatic cholestasis, extrahepatic biliary obstruction, acute cholangitis similar, fever, jaundice, abdominal pain, itching, right upper quadrant tenderness and hepatomegaly with elevated serum transaminase more degrees, the ALP increased significantly (2 to 10 times) in light of bilirubin increased significantly (34 ~ 500 μ mol / L), bile salt, lipoprotein X, GGT and cholesterol increased, and anti-mitochondrial antibody negative. In general to stop after 3 months to 3 years resume, a few disappear with a chronic bile duct progress of the process. Occasionally the bile duct damage is not irreversible, progress liver cirrhosis. Drug-induced autoimmune chronic hepatitis and chronic hepatitis clinical manifestations similar to the light can be asymptomatic, and the re-occurrence of hepatic encephalopathy associated with liver failure. Biochemical same performance and chronic viral hepatitis, serum transaminase, G-GT increased, leading to cirrhosis of progress with hypoproteinemia and coagulation dysfunction. 【Prognosis: The vast majority of patients resume after the withdrawal, in clinical and histological improvement, only a few weeks faster, the slow take years. A small number of serious and extensive liver damage caused fulminant hepatic failure, or progress to cirrhosis, a liver transplant if they do not, death will occur.