Hepatosis
| Classification according to ICD-10 | |
|---|---|
| K76.8 | Other specified diseases of the liver |
| K71.9 | Toxic liver disease, unspecified |
| ICD-10 online (WHO version 2019) | |
The hepatosis (cholestatic, even cholestatic) is an allergic-toxic conditional "swelling of" the bile ducts with biliary stasis and the resulting liver damage, usually with jaundice and severe itching , malaise, and sometimes fever. An obesity varying degrees often accompanies the disease.
diagnosis
As a diagnostic indicator, the alkaline phosphatase (AP) and often also the bile pigment bilirubin are greatly increased in the blood. The actual liver values (GOT and GPT) remain unaffected in the majority of cases. The GGT is moderately to significantly increased in hepatoses due to malnutrition, alcoholism and some drugs.
Causes of disease
The hepatosis is mostly due to drug intolerance .
Triggering drugs are:
- Psychotropic drugs : phenothiazines ( chlorpromazine 0.5 to 4%), other neuroleptics (less often), tri- / tetracyclic antidepressants , tranquilizers of the benzodiazepine type (very rarely)
- Antibiotics such as erythromycin (estolat) and the combination of amoxicillin / clavulanic acid
- Sulfonamides , antidiabetic agents and diuretics
- Arsenic compounds (rare today)
- Estrogens in hereditary women with a mutation in the MDR3 gene
- 17-alpha-substituted androgens ( anabolic steroids ) such as methyltestosterone
Cholostatic hepatosis can also occur with malnutrition or malnutrition and metabolic disorders ( e.g. storage diseases ). Long-term consumption of alcohol can also lead to this.
Treatment and prognosis
Treatment consists of discontinuing the causative drug and possibly giving short-term cortisone derivatives such as prednisone . If malnutrition and / or alcoholism are responsible, these factors are to be eliminated through optimal nutrition or strict alcohol abstinence.
Hepatosis usually has a good prognosis , i.e. it heals within a few weeks without permanent damage, but in exceptional cases it can also lead to death, for example through the development of primary biliary cirrhosis .
As with sulfonamides and macrolide antibiotics, it is often a matter of hypersensitivity to an entire group of drugs. Just like the drug itself, the use of drugs from the same group should be avoided in the future, as renewed exposure (re-exposure) could cause significantly more severe liver damage.
Differentiation from other liver diseases
In contrast to hepatitis, hepatosis is mainly a degenerative, not an inflammatory, liver disease. Other drug-induced liver damage such as cytolysis ( liver necrosis ) and fulminant liver failure (for example due to an overdose of paracetamol ) have a significantly poorer prognosis .
