scholarly journals Accuracy of gamma-glutamyl transpeptidase-to-platelet ratio (GPR), red cell distribution width (RDW), aspartate aminotransferase-to-platelet ratio index (APRI), and the fibrosis-4 index (FIB4) compared with liver biopsy in patients with drug-induced liver injury (DILI)

Medicine ◽  
2021 ◽  
Vol 100 (6) ◽  
pp. e24723
Author(s):  
Minjie Wan ◽  
Hongqin Xu ◽  
Dezhao Li ◽  
Le Wang ◽  
Xu Li
Keyword(s):  
Liver Injury ◽  
Liver Biopsy ◽  
Aspartate Aminotransferase ◽  
Red Cell ◽  
Cell Distribution ◽  
Gamma Glutamyl Transpeptidase ◽  
Drug Induced ◽  
Distribution Width ◽  
Drug Induced Liver Injury ◽  
Glutamyl Transpeptidase

scholarly journals Increased red cell distribution width predicts severity of drug-induced liver injury: a retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xu Li ◽  
Hongqin Xu ◽  
Pujun Gao
Keyword(s):  
Retrospective Study ◽  
Liver Injury ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Chinese Patients ◽  
Red Cell ◽  
Cell Distribution ◽  
Drug Induced ◽  
Distribution Width ◽  
Drug Induced Liver Injury

AbstractWe used a retrospective study design to evaluated the predictive value of red cell distribution width (RDW) for drug-induced liver injury (DILI) severity in Chinese patients with liver biopsy to assist with early DILI management. We included 164 DILI patients with complete laboratory information and medical history. We compared outcomes of 36 patients with severe DILI with outcomes of a control group of 128 patients with mild-to-moderate DILI. Multivariate analyses of risk factors for severe liver injury in Chinese patients with DILI revealed an estimated adjusted odds ratio (AOR) (95% CI) of 4.938 (1.088–22.412) in patients with drinking. Risk for serious liver injury was also increased significantly in patients with dyslipidemia [AOR (95% CI) 3.926 (1.282–12.026)], higher serum total bile acid (TBA) levels [AOR (95% CI) 1.014 (1.009–1.020)] and higher RDW [AOR (95% CI) 1.582 (1.261–1.986)]. The result for area under the curve of 0.905 for TBA levels indicated this variable had high diagnostic performance for predicting DILI severity. Based on an area under the curve value of 0.855, RDW also had superior diagnostic performance in prediction of DILI severity. This performance was not significantly different compared with TBA and was superior compared with other variables, which had area under values ranging from poor to failure (0.527–0.714).The risk for severe DILI was associated with drinking, dyslipidemia, higher TBA levels and RDW values. This study found that RDW and TBA levels were predictors of DILI severity in Chinese patients.

scholarly journals Comparison of Liver Biopsy Findings with the Digestive Disease Week Japan 2004 Scale for Diagnosis of Drug-Induced Liver Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Akemi Tsutsui ◽  
Yasuni Nakanuma ◽  
Kouichi Takaguchi ◽  
Satoko Nakamura ◽  
Hiroshi Shibata ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Biopsy ◽  
Digestive Disease ◽  
Drug Induced ◽  
Scale Evaluation ◽  
Drug Induced Liver Injury ◽  
Liver Injuries ◽  
Scale Scores ◽  
The Mean ◽  
Objective Tool

The liver biopsy remains a valuable tool in the diagnosis of drug-induced liver injury (DILI). The Digestive Disease Week Japan 2004 (DDW-J) scale proposed as an objective tool for the diagnosis of DILI has been widely used in Japan. So far, the histological features have not been compared with DDW-J scale in detail. Herein, we examined the correlation between liver biopsy findings and clinical features, particularly DDW-J scales. A total of 80 patients with liver injuries of unknown cause were enrolled. Based on the histological findings, these cases were categorized into 3 groups: A (DILI was strongly suspected), B (DILI was suspected), and C (DILI should be considered in the differential diagnosis). Histological groups and DDW-J scale were moderately correlated (κ=0.60). The mean total DDW-J scale scores were as follows: 4.89 for A, 3.26 for B, and 0.75 for C (p<0.05). While hepatocellular type was coincided in a majority of cases by histological and DDW-J scale evaluation, cholestatic type was not well coincided. In conclusion, biopsy findings and DDW-J scale were well correlated, and the hepatocellular type of liver injuries was well coincided by both evaluations, though there were several discrepant cases, particularly in cholestatic type.

scholarly journals The Implications of Liver Biopsy Results in Patients with Myeloproliferative Neoplasms Being Treated with Ruxolitinib

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Douglas Tremblay ◽  
Juan Putra ◽  
Alexander Vogel ◽  
Adam Winters ◽  
Ronald Hoffman ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Biopsy ◽  
Myeloproliferative Neoplasms ◽  
Extramedullary Hematopoiesis ◽  
Hepatic Toxicity ◽  
Drug Induced ◽  
Significant Treatment ◽  
Drug Induced Liver Injury ◽  
Liver Biopsies ◽  
Obliterative Portal Venopathy

Ruxolitinib is increasingly being utilized for the treatment of myelofibrosis and polycythemia vera, but the potential for hepatic toxicity is poorly understood. We performed a retrospective review of hepatic damage occurring in patients with myeloproliferative neoplasms receiving ruxolitinib. Relevant histologic images of liver biopsies were reviewed by an experienced liver pathologist and reported to a multidisciplinary team including hepatology and hematology. A variety of liver pathology was observed including extramedullary hematopoiesis, obliterative portal venopathy, and drug-induced liver injury. In all cases reviewed, the liver biopsy had significant treatment implications. We conclude that hepatology referral and liver biopsy in patients receiving ruxolitinib therapy with biochemical evidence of liver injury reveals a variety of etiologies which have significant treatment impact. Clinicians should be aware of the potential causes of liver damage in this population and initiate prompt referral and liver biopsy.

Drug-Induced Liver Injury

2015 ◽  
Vol 139 (7) ◽  
pp. 876-887 ◽  
Author(s):  
Kurt Fisher ◽  
Raj Vuppalanchi ◽  
Romil Saxena
Keyword(s):  
Liver Injury ◽  
Liver Biopsy ◽  
Clinical Laboratory ◽  
The United States ◽  
Prognostic Information ◽  
Self Medication ◽  
Drug Induced ◽  
Pattern Of Injury ◽  
Tertiary Referral Center ◽  
Drug Induced Liver Injury

Context Drug-induced liver injury (DILI) represents a diverse set of responses following exposure to any manufactured or naturally occurring chemical compound. Drug-induced liver injury is of major concern owing to the ever increasing number of compounds introduced into the market for treatment of various diseases as well as the increasing popularity of herbals, which lend themselves to self-medication but are not rigorously regulated. Objective To provide an overview of the prevalence, classification, and diagnosis of DILI with emphasis on pathogenesis and the role of a liver biopsy. To focus on the most common, emerging, and herbal agents that cause DILI with emphasis on the histologic pattern of injury observed. Data Sources A review of the literature was drawn from the PubMed (US National Library of Medicine) repository, textbooks, and online databases. All figures were taken from cases seen at our tertiary referral center, which is 1 of 12 participating sites in the National Institutes of Health–funded Drug-Induced Liver Injury Network. Conclusions Drug-induced liver injury due to prescription, over-the-counter, and herbal products is a major cause of liver disease in the United States and around the world. Diagnosis of DILI is challenging because there is no single clinical, laboratory, or histologic feature specific to DILI. Accurate diagnosis requires establishing a causal relationship with the suspected agent and excluding competing causes of liver injury. The liver biopsy is an essential component in the management of DILI by offering clues to the underlying pathogenesis, providing prognostic information, and guiding therapy.

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