The four main symptoms of drug-induced hepatitis

Drug-induced hepatitis mostly occurs in people who are in poor health. Because they need to take medication frequently to treat their bodies, some of the medications they take may damage the liver, leading to drug-induced hepatitis. Many people don’t know what symptoms will occur when drug-induced hepatitis occurs, so today I will share with you some symptoms of drug-induced hepatitis.

1. Clinical manifestations are related to the types of liver-damaging drugs and the mechanisms that cause liver disease. Drug-induced hepatitis can be divided into acute and chronic categories based on its clinical characteristics. Among acute liver cell damage, acute drug-induced hepatitis is the most common. When liver cell necrosis is the main feature, the clinical manifestations are similar to acute viral hepatitis. Symptoms of drug-induced hepatitis often include fever, fatigue, poor appetite, jaundice and elevated serum transaminases (2 to 30 times the normal value). ALP and albumin are less affected. Hyperbilirubinemia and prolonged prothrombin time are related to the severity of liver damage. For patients with mild symptoms, recovery can be achieved in a short period of time (weeks to months) after stopping medication; for patients with severe symptoms, liver failure, progressive jaundice, bleeding tendency and hepatic encephalopathy may occur, often leading to death.

2. Acute drug-induced hepatitis with allergic reactions as the main feature is often accompanied by fever, rash, jaundice, lymphadenopathy, and moderate elevation of serum transaminase, bilirubin, and ALP. The history of drug exposure is usually short (within 4 weeks).

3. Drug-induced hepatitis with cholestasis as the main feature has clinical and laboratory manifestations similar to those of intrahepatic cholestasis, extrahepatic bile duct obstruction, and acute cholangitis, with symptoms of fever, jaundice, upper abdominal pain, itching, right upper abdominal tenderness, and hepatomegaly. The manifestations of drug-induced hepatitis are accompanied by elevated serum transaminase concentrations. ALP increased significantly (2-10 times), conjugated bilirubin increased significantly (34-500 μmol/L), bile salts, lipoprotein X, GGT and cholesterol increased, while anti-mitochondrial antibodies were negative. Generally, recovery occurs 3 months to 3 years after stopping medication. In a few cases, bile duct disappearance occurs with a chronic progressive process. Occasionally, bile duct damage is irreversible and progresses to cirrhosis. 4. The clinical manifestations of drug-induced chronic hepatitis are similar to those of autoimmune chronic hepatitis, ranging from mild to asymptomatic to severe to liver failure with hepatic encephalopathy. The biochemical manifestations of drug-induced hepatitis are the same as those of chronic viral hepatitis, with elevated serum transaminases and GGT. The progressive type leads to cirrhosis with hypoproteinemia and coagulation dysfunction.

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