关键词: 药物性肝损伤, 自身免疫性肝炎, 组织学特征

Abstract: Objective To investigate the serological and histological characteristics of drug-induced liver injury (AL-DILI) patients with autoimmune-like manifestations.Methods Seventy-five DILI patients admitted to hospital between July 2016 and August 2021 were divided into two groups according to whether they had autoimmune manifestations. The basic conditions, serological and histological characteristics of the patients were compared.Results 87.9% of the patients in the observation group were female, which were significantly higher than that of 61.9% in the control group (P<0.05). Comparing the serological characteristics of the observation group and the control group, The levels of AST, GGT, globulin, IgG and IgA in the observation group were 220.0 (79.9, 398.9) U/L, 187.5 (105.8, 299.5) U/L, 30.6 (27.9, 34.1) g/L, 14.9 (12.8, 18.2) g/L and 2.9 (2.3, 3.4) g/L, respectively, which were significantly higher than those of [95.1 (60.3, 276.5) U/L, 104.5 (51.5, 205.5) U/L, 26.3 (24.4, 28.0) g/L, 10.1 (8.7, 12.6) g/L and 2.0 (1.5, 2.8) g/L] in the control group (P<0.05). The level of ChE was 5626 (4812, 7356) U/L in the observation group, which was significantly lower than that of [6981 (5328, 8096) U/L] in the control group (P<0.05). Comparing the histological characteristics of the observation group and the control group, the proportion of eosinophil and/or neutrophil infiltration in the observation group was 54.8%, which was significantly higher than that of 15.2% in the control group (P<0.05).Conclusion The difference of serological and histological characteristics is helpful to distinguish AL-DILI from simple DILI, which provides a theoretical basis for their differential diagnosis.

Key words: Drug-induced liver injury, Autoimmune hepatitis, Histological characteristics