Drug-induced hepatitis

Abstract

Aim. To improve diagnosis and treatment of drug-induced hepatitis: to specify drugs with hepatotoxic effect, clinical variants of drug-induced hepatic diseases, management of drug-induced hepatitis (DIH). Materials and methods. Of 2300 examinees with hepatic lesions, 62 were diagnosed to have DIH. Measurements were made of serum levels of bilirubin and its fractions, total protein, some protein fractions, markers of hepatitis A, B, C, activity of aminotransferases (AIAT and AsAT), alkaline phosphatase (AP), glutamate dehydrogenase (GIDG), sorbitol dehydrogenase (SDG), gamma-glutamate transpeptidase (GGTP), choline esterase (CE). Timolveronal test was made. On demand, tests were made for CEA, AFP; device examinations were made: ultrasound investigation, computed tomography of the abdominal organs, endoscopic retrograde pancreatography, laparoscopy with hepatic biopsy, transcutaneous hepatic biopsy, laparotomy with cholecystocholangiography. Results. A direct relationship of hepatitis with drugs intake was revealed in all the patients. Development of drug-induced intrahepatic cholestasis in patients on long-term treatment with anticancer drugs was accompanied with affection of cellular organellas and progressive destruction of small interlobular ducts provoking intrahepatic cholestasis and depletion of natural glutathione. Conclusion. Correction of intrahepatic cholestasis and deficiency of endogenic glutathione is successfully carried out with heptral.