Drug Induced Liver Disease (cont.)

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What types of liver disease do drugs cause?

Drugs and chemicals can cause a wide spectrum of liver injury. These include:

  • Mild elevations in blood levels of liver enzymes without symptoms or signs of liver disease
  • Hepatitis (inflammation of liver cells)
  • Necrosis (death of liver cells) that often is caused by more severe hepatitis
  • Cholestasis (decreased secretion and/or flow of bile)
  • Steatosis (accumulation of fat in the liver)
  • Cirrhosis (advanced scarring of the liver) as a result of chronic hepatitis, cholestasis, or fatty liver
  • Mixed disease, for example both hepatitis and necrosis of liver cells, hepatitis and fat accumulation, or cholestasis and hepatitis.
  • Fulminant hepatitis with severe, life threatening liver failure
  • Blood clots in the veins of the liver

Elevated blood levels of liver enzymes

Many drugs cause mild elevations in blood levels of liver enzymes without symptoms or signs of hepatitis. AST, ALT, and alkaline phosphatase are enzymes that normally reside within the cells of the liver and bile ducts. Some drugs can cause these enzymes to leak from the cells and into the blood, thus elevating the blood levels of the enzymes. Examples of drugs that more commonly cause elevations of liver enzymes in the blood include the statins (used in treating high blood cholesterol levels) some antibiotics, some antidepressants (used in treating depression), and some medications used for treating diabetes, tacrine (Cognex), aspirin, and quinidine (Quinaglute, Quinidex).

Since these patients typically experience no symptoms or signs, the elevations of liver enzymes usually are discovered when blood tests are performed as a part of an annual physical examination, as pre-operative screening, or as a part of periodic monitoring for drug toxicity. Typically, these abnormal levels will become normal shortly after stopping the drug, and there usually is no long-term liver damage. With some drugs, low levels of abnormal liver enzymes are common and don't appear to be associated with important (severe or progressive) liver disease, and the patient may continue taking the drug.

Medically Reviewed by a Doctor on 1/22/2014

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Drug-Induced Liver Disease - Describe Your Experience Question: The symptoms of drug-induced liver disease can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Drug-Induced Liver Disease - Causes Question: What caused your drug-induced liver disease?
Drug-Induced Liver Disease - Hepatitis Question: Did you have drug-induced hepatitis? Please describe your experience.
Drug-Induced Liver Disease - Cirrhosis Question: Were you or someone you know diagnosed with drug-induced cirrhosis? Please share your story.
Drug-Induced Liver Disease - Treatment Question: In addition to stopping the drug that caused liver disease, what types of treatment did you receive?

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