ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2019
Histologic pattern is better correlated with clinical outcomes than biochemical classification in patients with drug-induced liver injury.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update.Hepatology international · 2024Guideline
- [Chinese guideline for diagnosis and management of drug-induced liver injury (2023 version)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Guideline
- Successful treatment of laparoscopic surgery in treating acute diffuse peritonitis due to drug-induced acute liver injury: a case description.Quantitative imaging in medicine and surgery · 2026Article
- Computed tomography manifestations of drug-induced liver injury according to type and severity of injury.Quantitative imaging in medicine and surgery · 2025Article
- Machine learning-enhanced confocal Raman imaging enables label-free diagnosis and spatial metabolic profiling of isoniazid-induced hepatotoxicity.Theranostics · 2025Article
- Histopathological characteristics of liver biopsy performed at different time points in drug-induced liver injury.Histology and histopathology · 2024Observational
- Histopathological Features Predicting Long-term Clinical Outcomes in Patients with Vanishing Bile Duct Syndrome.Journal of clinical and translational hepatology · 2023Article
- Article
- [Drug-induced liver injury-significance of pathology].Der Pathologe · 2020Review
- [Liver biopsy diagnostics-times are changing].Der Pathologe · 2020Article
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17 authors.
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Abstract
Histologically, drug-induced liver injury could be classified into acute hepatitis, chronic hepatitis, acute cholestasis, chronic cholestasis, and cholestatic hepatitis. The correlation between these histologic patterns and long-term clinical outcomes has not been well established. Therefore, we conducted a retrospective cohort study to investigate the association of histologic patterns and long-term clinical outcomes defined as biochemical normalization, persistent abnormal liver biochemistry or death at designated time points. In this study, biochemical classification was determined by R-values; histologic injury pattern was determined by morphological features. Predictive ability of clinical outcomes by these two classifications was assessed using Receiver Operating Characteristic Curves. Logistic regression was performed to identify histologic factors associated with outcomes. Totally, 88 patients with drug-induced liver injury were included for final analysis. Biochemical and histologic classification were consistent in 50 (57%) cases. 53 (60%) cases showed biochemical normalization within 6 months, and a further 11 (13%), 16 (18%), and 6 (7%) cases within 1, 2, and 3 years, respectively. Compared with biochemical classification, histologic injury pattern had better predictive ability for abnormal biochemistry at 6 months (Areas under Receiver Operating Characteristic Curves 0.92 versus 0.60, P < 0.001) and 1 year (Areas under Receiver Operating Characteristic Curves 0.94 versus 0.69, P < 0.001). Interlobular bile duct loss in >25% portal areas was independently associated with abnormal biochemistry at 6 months, 1 year, and 2 years. In conclusion, histologic injury pattern is better correlated with clinical outcome at 6 months and 1 year than biochemical classification. Moderate bile duct loss is an important histologic feature associated with persistent biochemical abnormality at 6 months, 1 year, and 2 years.
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