Value of liver biopsy in the diagnosis of drug-induced liver injury.
Value of liver biopsy in the diagnosis of drug-induced liver injury.
复制标题
肝活检在药物性肝损伤诊断中的价值
DOI：
10.1016/j.jhep.2021.12.043
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发表时间：
2022-05
影响因子：
25.7
通讯作者：
Kleiner, David E.
中科院分区：
文献类型：
--
作者：
Ahmad, Jawad;Barnhart, Huiman X.;Bonacini, Maurizio;Ghabril, Marwan;Hayashi, Paul H.;Odin, Joseph A.;Rockey, Don C.;Rossi, Simona;Serrano, Jose;Tillmann, Hans L.;Kleiner, David E.
The utility of liver biopsy in diagnosing or staging idiosyncratic drug-induced liver injury (DILI) is unclear. The aim of this study was to determine whether liver histology impacted causality assessment in suspected DILI using a novel simulation model. Fifty patients enrolled in the DILI Network (DILIN) who had liver biopsies performed within 60 days of DILI onset were randomly selected. All had standard DILIN consensus causality scoring using a 5-point scale (1=definite, 2=highly likely, 3=probable, 4=possible, 5=unlikely) based on 6-month post-injury data. Three experienced hepatologists independently performed causality assessment using redacted case records with the biopsy and selected post-biopsy laboratory data removed. The 3 hepatologists also reviewed the liver histology with a hepatopathologist and then repeated causality assessment for each case. Of the 50 cases, there were 42 high causality DILI Cases (1,2 or 3) and 8 low causality cases. The hepatologists judged that liver biopsy was indicated in 62% of patients; after histology review, biopsy was judged to have been helpful in 70% of patients. Histology review changed the causality score in 68% of patients, with an increase in DILI likelihood in 48% and a decrease in 20%. Biopsy results changed diagnostic certainty from less certain (3 or 4) to highly certain (1,2 or 5) in 38% of patients. Liver histologic findings may help clarify the diagnosis of DILI. Histology appears to be particularly helpful in cholestatic or equivocal cases of DILI (possible or probable), shifting assessment toward a greater or less certainty of a DILI diagnosis. The results of a liver biopsy in patients with suspected drug-induced liver injury (DILI) can help physicians in being more certain that the liver injury is due to a drug or another cause.
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影响因子：
4.2
作者：
Fontana RJ;Watkins PB;Bonkovsky HL;Chalasani N;Davern T;Serrano J;Rochon J;DILIN Study Group
通讯作者：
DILIN Study Group
DOI：
10.1002/hep.28967
发表时间：
2017-04
期刊：
Hepatology (Baltimore, Md.)
影响因子：
--
作者：
Bonkovsky HL;Kleiner DE;Gu J;Odin JA;Russo MW;Navarro VM;Fontana RJ;Ghabril MS;Barnhart H;Hoofnagle JH;U.S. Drug Induced Liver Injury Network Investigators
通讯作者：
U.S. Drug Induced Liver Injury Network Investigators
影响因子：
29.4
作者：
Chalasani N;Bonkovsky HL;Fontana R;Lee W;Stolz A;Talwalkar J;Reddy KR;Watkins PB;Navarro V;Barnhart H;Gu J;Serrano J;United States Drug Induced Liver Injury Network
通讯作者：
United States Drug Induced Liver Injury Network
影响因子：
13.5
作者：
Suzuki, Ayako;Brunt, Elizabeth M.;Bjoernsson, Einar
通讯作者：
Bjoernsson, Einar
影响因子：
13.5
作者：
Rockey, Don C.;Seeff, Leonard B.;Rochon, James;Freston, James;Chalasani, Naga;Bonacini, Maurizio;Fontana, Robert J.;Hayashi, Paul H.
通讯作者：
Hayashi, Paul H.