Clinical Significance Of Antibody Concentration In Drug-induced Liver Injury

BackgroundDrug induced liver injury is refers to chemical by all kinds of prescription or over-the-counter drugs,biologics,traditional Chinese medicine,natural medicine,health care products,dietary supplements and their metabolic products and accessories,and other caused by liver damage.The pathogenesis of DILI is unknown,but most scholars think that includes drug directly injury and idiosyncrasy of liver damage,Patients with clinical work in DILI autoantibody positive(mainly the ANA)is very common.The relationship between the degree of ANA drops and disease of the clinical features,prognosis and outcome is less reported at home and abroad.This study collected 44 patients' clinical indicators who after liver biopsy examination diagnosis of DILI,and analyzing the serum ANA drop degree and its clinical characteristics,laboratory indexes and liver pathology and disease outcome,in order to provide help for the clinical work.ObjectiveTo increase the cognition for drug-induced liver injury with antibody positive,and Strengthen the importance for clinical doctors to “drug-induced liver injury associated with autoimmune phenomenon",In order to improve the diagnosis and treatment of the disease and follow-up.MethodsCollect 44 patients who were admitted to The First Affiliated Hospital of Zhengzhou University from 2014 to 2016 and diagnosed with DILI.And carries on the AIH facilitation,all less 7 points.Gatherring the clinical features,laboratory indexes(biochemical indicators,autoantibodies,etc.)and liver histology index,clinical outcomes,etc.Results1.ANA negative groups,low degree of group,set group of degrees in clinical symptoms(such as With jaundice and coagulation dysfunction)has statistical differences.2.Age,liver biochemistry indexes of three groups of classification(ALT,AST,GGT and ALP,TDBIL)comparison between results suggest that differences were not statistically significant.And immunology related indicators GLOB,IgG,alexin and CRP have statistical significance.3.All patients have liver biopsy and pathological classification results show that three groups of the lobule focal necrosis with portal area of inflammation,inflammation and centrilobular necrosis and fusion,bridging necrosis has significant differences.Conclusion1.Clinical routine biochemical indexes of the liver(ALT,AST,GGT and ALP)can't identify the drug-induced liver injury and associated with autoimmune phenomena of DILI.But the rise of GLOB,IgG,alexin and CRP still has certain reference value,underwent liver biopsy in order to make clear diagnosis as needed.2.In bad response of liver biochemical indexes after conventional treatment,repeated recurrence,we should consider whether there is a potential autoimmune factors caused by liver damage.Especially with high ANA drop degree,these patients may require small doses of hormones/short-term maintain immune inhibitors.3.In patients with positive ANA dripping degrees higher,Hormone therapy in the treatment process to probability,added with small doses of the hormone to maintain longer time than sheer DILI.When considering stop using hormones to clinicians more cautious assessment of his condition.Even reached complete biochemical responses,still need to closely follow up.