Drug-induced cirrhosis

Introduction to drug-induced cirrhosis Liver damage caused by medication can cause drug-induced cirrhosis. With the emergence of new drugs, there are more than 10,000 kinds of drugs currently used in clinical practice, most of which need to be metabolized by the liver, and the incidence of drug-induced hepatitis is also increasing. Hepatic cirrhosis (hepaticsclerosis) is a clinically common chronic progressive liver disease with diffuse liver damage caused by long-term or repeated action of one or more causes. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: upper gastrointestinal bleeding, ascites, hepatic encephalopathy

Cause of drug-induced cirrhosis

Cause:

There are more than 200 kinds of drugs that can cause different liver damage, including non-steroidal antipyretic and analgesic drugs such as acetaminophen, muscle relaxants, anesthetics, anticonvulsants, antibiotics, antifungals and antiparasitic drugs. , anti-tuberculosis drugs, anticancer drugs and immunosuppressive drugs, hormone drugs, oral hypoglycemic agents, antithyroid drugs, H2-receptor blockers, psychotropic drugs, etc., according to statistics, patients with drug-induced liver damage , accounting for about 10% to 15% of all drug-reactive cases, the incidence is second only to skin and mucous membrane damage and drug fever.

Drug-induced damage can be divided into predictable (usually dose-related) and non-predictive (or idiosyncratic, often dose-independent), predictable damage can replicate animal models, often damaged to certain parts of the liver lobules, Because of the dose-related, it is said to be a direct hepatotoxic drug. Non-predictive injury is often diffuse. It is presumed to be an allergic reaction to the drug. The immune mechanism is the direct cause of hepatocyte injury. Non-predictive damage cannot be replicated. Animal model.

Drug-induced cirrhosis prevention

1. Drug-induced cirrhosis, the focus is on prevention and prevention of early drug-induced injury. For example, liver function should be measured regularly during drug treatment. For patients with existing liver disease or kidney disease, liver function changes during drug use should be monitored. Those with a history of drug-induced liver damage should avoid using the same or similar chemical structure drugs. For drug-induced chronic active hepatitis or liver fibrosis, anti-fibrotic drugs such as Danshen and Angelica should be applied as soon as possible.

2. In addition, according to the mechanism of liver damage caused by drugs, the contract of targeted drugs and therapeutic drugs can be selected to prevent the occurrence of liver damage. For example, methotrexate can inhibit the activity of cytochrome P450, and acetylcysteine can promote the synthesis of GSH. Acetylsalicylic acid can reduce the concentration of calcium ions and the like.

Drug cirrhosis complications Complications upper gastrointestinal bleeding, ascites, hepatic encephalopathy

Most of the complications are upper gastrointestinal bleeding, ascites, and hepatic encephalopathy.

Symptoms of drug-induced cirrhosis Common symptoms Liver leaf atrophy Loss of appetite, bloating, liver stellate cell hyperplasia, black stool, liver texture, hard ascites, jaundice, upper gastrointestinal bleeding, weight loss

1. Taking a history of drugs that damage the liver, especially drugs that cause chronic active hepatitis, such as bisphenol phenate, methyldopa, acetaminophen, aspirin, amiodarone, sulfa drugs, etc., individual drugs are occult Progress until cirrhosis, such as methotrexate.

2. Clinical manifestations of cirrhosis, such as portal hypertension and its complications, upper gastrointestinal bleeding, ascites, hepatic encephalopathy, etc.

3. Liver biopsy confirmed liver cirrhosis.

4. Except for other causes of cirrhosis, such as various viral hepatitis, serum markers are negative, except for cardiogenic cirrhosis.

Drug cirrhosis

Abdominal B-ultrasound examination, nuclear magnetic resonance (CT) for initial diagnosis, liver biopsy to confirm the diagnosis.

Diagnosis and identification of drug-induced cirrhosis

According to the medical history, clinical manifestations and laboratory data is not difficult to make a diagnosis.

It is differentiated from cirrhosis caused by other causes, such as viral hepatitis, negative serum markers, and external cardiogenic cirrhosis.

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