Current status of the pathogenesis, diagnosis, and treatment of drug-induced cholestasis
10.3969/j.issn.1001-5256.2019.02.003
- VernacularTitle:药物性胆汁淤积的发病机制及诊疗现状
- Author:
Meng LIU
1
;
Xuanzi YANG
;
Yuecheng YU
Author Information
1. General Hospital of Eastern Theater Command & Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, China
- Publication Type:Research Article
- Keywords:
drug-induced liver injury;
cholestasis;
diagnosis;
therapeutics
- From:
Journal of Clinical Hepatology
2019;35(2):252-257
- CountryChina
- Language:Chinese
-
Abstract:
Drug-induced cholestasis (DRIC) mainly includes cholestasis-type and mixed-type drug-induced liver injury (DILI). The Roussel Uclaf Causality Assessment Method scale should be used to determine the causality between drug and cholestasis and other etiologies should be excluded. Liver biopsy may help with differential diagnosis. Drugs should be stopped after the development of DRIC to avoid stimulation, and ursodeoxycholic acid should be administered for treatment. DRIC has a complex pathogenesis, which involves the direct toxicity of drugs and their metabolites on hepatocytes and the biliary tree, immune and inflammatory response, gene polymorphism and inhibition of key enzymes and transporters in the pathways of drug metabolism and efflux, and HLA gene polymorphisms. Clarification of these pathogeneses helps with the early warning, prevention, and optimized treatment of DRIC.
