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药物性肝损伤与自身免疫性肝炎的鉴别诊断与治疗策略

卞兆连 邵建国 马雄

引用本文:
Citation:

药物性肝损伤与自身免疫性肝炎的鉴别诊断与治疗策略

DOI: 10.3969/j.issn.1001-5256.2018.06.003
详细信息
  • 中图分类号: R575

Differential diagnosis of drug-induced liver injury and autoimmune hepatitis and related therapeutic strategies

  • 摘要: 药物性肝损伤(DILI)与自身免疫性肝炎(AIH)的临床及组织学表现存在较多相似点,给临床医师的鉴别诊断带来困难。通过分别阐述DILI与AIH的关系、临床表现及组织学的异同点,帮助临床医师更好地鉴别DILI与AIH。总结了DILI与AIH治疗方案的选择,尤其着重介绍了在两者鉴别存在困难时,如何根据患者的病情选择不同的治疗策略,最终明确诊断。

     

  • [1]KULLAK-UBLICK GA, ANDRADE RJ, MERZ M, et al.Druginduced liver injury:Recent advances in diagnosis and risk assessment[J].Gut, 2017, 66 (6) :1154-1164.
    [2]WANG Q, YANG F, MIAO Q, et al.The clinical phenotypes of autoimmune hepatitis:A comprehensive review[J].J Autoimmun, 2016, 66:98-107.
    [3]LUCENA MI, KAPLOWITZ N, HALLAL H, et al.Recurrent druginduced liver injury (DILI) with different drugs in the Spanish Registry:The dilemma of the relationship to autoimmune hepatitis[J].J Hepatol, 2011, 55 (4) :820-827.
    [4]WEILER-NORMANN C, SCHRAMM C.Drug induced liver injury and its relationship to autoimmune hepatitis[J].J Hepatol, 2011, 55 (4) :747-749.
    [5]PARIENTE EA, HAMOUD A, GOLDFAIN D, et al.Hepatitis caused by clometacin (Duperan) .Retrospective study of 30 cases.A model of autoimmune drug-induced hepatitis?[J].Gastroenterol Clin Biol, 1989, 13 (10) :769-774.
    [6]European Association for the Study of the Liver.EASL Clinical Practice Guidelines:Autoimmune hepatitis[J].J Hepatol, 2015, 63 (4) :971-1004.
    [7]CZAJA AJ.Drug-induced autoimmune-like hepatitis[J].Dig Dis Sci, 2011, 56 (4) :958-976.
    [8]PERDICES EV, MEDINA-CALIZ I, HERNANDO S, et al.Hepatotoxicity associated with statin use:Analysis of the cases included in the Spanish Hepatotoxicity Registry[J].Rev Esp Enferm Dig, 2014, 106 (4) :246-254.
    [9]GUZMAN G, KALLWITZ ER, WOJEWODA C, et al.Liver injury with features mimicking autoimmune hepatitis following the use of Black Cohosh[J].Case Rep Med, 2009, 2009:918156.
    [10]EFE C, PURNAK T, OZASLAN E, et al.Drug-induced autoimmune hepatitis caused by anti-tumor necrosis factor alpha agents[J].Hepatology, 2010, 52 (6) :2246-2247.
    [11]RODRIGUES S, LOPES S, MAGRO F, et al.Autoimmune hepatitis and anti-tumor necrosis factor alpha therapy:A single center report of 8 cases[J].World J Gastroenterol, 2015, 28, 21 (24) :7584-7588.
    [12]TERZIROLI BERETTA-PICCOLI B, MIELI-VERGANI G, BERTOLI R, et al.Atovaquone/proguanil-induced autoimmune-like hepatitis[J].Hepatol Commun, 2017, 1 (4) :293-298.
    [13] de BOER YS, KOSINSKI AS, URBAN TJ, et al.Features of autoimmune hepatitis in patients with drug-induced liver injury[J].Clin Gastroenterol Hepatol, 2017, 15 (1) :103-112, e102.
    [14]CHALASANI N, BONKOVSKY HL, FONTANA R, et al.Features and outcomes of 899 patients with drug-induced liver injury:The DILIN prospective study[J].Gastroenterology, 2015, 148 (7) :1340-1352, e1347.
    [15]ANDRADE RJ, LUCENA MI, FERNANDEZ MC, et al.Drug-induced liver injury:An analysis of 461 incidences submitted to the Spanish registry over a 10-year period[J].Gastroenterology, 2005, 129 (2) :512-521.
    [16]DEVARBHAVI H, RAJ S, ARADYA VH, et al.Drug-induced liver injury associated with Stevens-Johnson syndrome/toxic epidermal necrolysis:Patient characteristics, causes, and outcome in36 cases[J].Hepatology, 2016, 63 (3) :993-999.
    [17]LIWINSKI T, SCHRAMM C.Autoimmune hepatitis-update on clinical management in 2017[J].Clin Res Hepatol Gastroenterol, 2017, 41 (6) :617-625.
    [18]ZHANG WC, ZHAO FR, CHEN J, et al.Meta-analysis:Diagnostic accuracy of antinuclear antibodies, smooth muscle antibodies and antibodies to a soluble liver antigen/liver pancreas in autoimmune hepatitis[J].PLo S One, 2014, 9 (3) :e92267.
    [19]SONTHALIA N, RATHI PM, JAIN SS, et al.Natural history and treatment outcomes of severe autoimmune hepatitis[J].J Clin Gastroenterol, 2017, 51 (6) :548-556.
    [20]BALITZER D, SHAFIZADEH N, PETERS MG, et al.Autoimmune hepatitis:review of histologic features included in the simplified criteria proposed by the international autoimmune hepatitis group and proposal for new histologic criteria[J].Mod Pathol, 2017, 30 (5) :773-783.
    [21]KLEINER DE.Histopathological challenges in suspected drug-induced liver injury[J].Liver Int, 2018, 38 (2) :198-209.
    [22]SUZUKI A, BRUNT EM, KLEINER DE, et al.The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury[J].Hepatology, 2011, 54 (3) :931-939.
    [23]DANAN G, TESCHKE R.Drug-induced liver injury:Why is the roussel uclaf causality assessment method (RUCAM) still used 25years after its launch?[J].Drug Saf, 2018.[Epub ahead of print].
    [24]TESCHKE R, SCHULZE J, EICKHOFF A, et al.Drug induced liver injury:Can biomarkers assist RUCAM in causality assessment?[J].Int J Mol Sci, 2017, 18 (4) :e803.
    [25]Drug-induced Liver Disease Study Group, Chinese Society of Hepatology, Chinese Medical Association.Guidelines for the management of drug-induced liver injury[J].J Clin Hepatol, 2015, 31 (11) :1752-1769. (in Chinese) 中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].临床肝胆病杂志, 2015, 31 (11) :1752-1769.
    [26]Chinese Society of Hepatology, Chinese Medical Association;Chinese Society of Gastroenterology, Chinese Medical Association;Chinese Society of Infectious Diseases, Chinese Medical Association.Consensus on the diagnosis and management of autoimmune hepatitis (2015) [J].J Clin Hepatol, 2016, 32 (1) :9-22. (in Chinese) 中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会.自身免疫性肝炎诊断和治疗共识 (2015) [J].临床肝胆病杂志, 2016, 32 (1) :9-22.
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  • 收稿日期:  2018-03-31
  • 出版日期:  2018-06-20
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