Drug-induced hepatic injury : analysis of clinicopathological patterns with the help of voluntary reporting

This study is focused on drug-induced hepatic injury. Drug-induced hepatic injury includes many different patterns varying from necrosis or cholestasis to vascular and neoplastic disorders. These may present acutely or insidiously after years of use of the suspected drug. Some drugs are the cause of a mainly hepatocellular pattern of injury (e.g.methyldopa), whereas the pattern caused by other drugs is predominantly cholestatic (e.g. contraceptive steroids) (2). The diagnosis 'drug-induced hepatic injury' is often made by exclusion of other potential factors. Unlike several forms of viral hepatitis where serologic investigation may confirm the diagnosis (e.g. hepatitis A and B, infectious mononucleosis), in cases of drug-induced hepatic injury a specific marker is usually absent. Knowledge about the pattern of hepatic injury which is most frequently caused by a particular drug would be a help in the differential diagnosis.