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Infectious Disease Reports
Volume 15
Issue 6
10.3390/idr15060066
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Article

Utility of Liver Biopsy in the Diagnosis and Management of Possible Drug-Induced Liver Injury in Patients Receiving Antituberculosis Therapy: A Retrospective Study

by
Gina Gualano
1,*,
Drieda Zace
2,
Silvia Mosti
1,
Paola Mencarini
1,
Maria Musso
1,
Raffaella Libertone
1,
Carlotta Cerva
1,
Delia Goletti
1,
Alessia Rianda
1,
Franca Del Nonno
3,
Laura Falasca
3 and
Fabrizio Palmieri
1
1
Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
2
Clinical Infectious Diseases, Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
3
Pathology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
*
Author to whom correspondence should be addressed.
Infect. Dis. Rep. 2023, 15(6), 735-746; https://doi.org/10.3390/idr15060066
Submission received: 23 September 2023 / Revised: 17 November 2023 / Accepted: 22 November 2023 / Published: 28 November 2023
(This article belongs to the Section Tuberculosis and Mycobacteriosis)
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Abstract

Background: Drug-induced liver injury (DILI) secondary to ATT treatment (TB-DILI) is reported in 2–28% of patients. We present here a series of clinical cases of suspected DILI arising during antituberculosis treatment, studied with the aid of liver biopsy. Methods: this was a retrospective descriptive study including 10 tuberculosis patients who underwent liver biopsy for suspected TB-DILI at the “Lazzaro Spallanzani” Institute from 2017 to 2022. Results: Ten patients who underwent LB were extracted from the database and included in the retrospective study cohort. According to the clinical classification, eight patients had hepatocellular liver injury, one patient had cholestatic injury, and another had mixed-type injury. Histopathological diagnosis revealed liver damage due to DILI in 5/10 (50%) cases. In one case, liver biopsy showed necrotizing granulomatous hepatitis. Conclusions: Severe and persistent elevation of hepatic transaminases, hepatic cholestasis despite discontinuation of therapy, and other suspected hepatic conditions are indications for liver biopsy, which remains a valuable tool in the evaluation of selected tuberculosis patients with suspected DILI for many reasons. However, the decision to perform a liver biopsy should be based on clinical judgment, considering the benefits and risks of the procedure.
Keywords: antitubercular drugs; hepatotoxicity; liver injury; liver biopsy; histology; DILI diagnosis; DILI management antitubercular drugs; hepatotoxicity; liver injury; liver biopsy; histology; DILI diagnosis; DILI management

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MDPI and ACS Style

Gualano, G.; Zace, D.; Mosti, S.; Mencarini, P.; Musso, M.; Libertone, R.; Cerva, C.; Goletti, D.; Rianda, A.; Del Nonno, F.; et al. Utility of Liver Biopsy in the Diagnosis and Management of Possible Drug-Induced Liver Injury in Patients Receiving Antituberculosis Therapy: A Retrospective Study. Infect. Dis. Rep. 2023, 15, 735-746. https://doi.org/10.3390/idr15060066

AMA Style

Gualano G, Zace D, Mosti S, Mencarini P, Musso M, Libertone R, Cerva C, Goletti D, Rianda A, Del Nonno F, et al. Utility of Liver Biopsy in the Diagnosis and Management of Possible Drug-Induced Liver Injury in Patients Receiving Antituberculosis Therapy: A Retrospective Study. Infectious Disease Reports. 2023; 15(6):735-746. https://doi.org/10.3390/idr15060066

Chicago/Turabian Style

Gualano, Gina, Drieda Zace, Silvia Mosti, Paola Mencarini, Maria Musso, Raffaella Libertone, Carlotta Cerva, Delia Goletti, Alessia Rianda, Franca Del Nonno, and et al. 2023. "Utility of Liver Biopsy in the Diagnosis and Management of Possible Drug-Induced Liver Injury in Patients Receiving Antituberculosis Therapy: A Retrospective Study" Infectious Disease Reports 15, no. 6: 735-746. https://doi.org/10.3390/idr15060066

APA Style

Gualano, G., Zace, D., Mosti, S., Mencarini, P., Musso, M., Libertone, R., Cerva, C., Goletti, D., Rianda, A., Del Nonno, F., Falasca, L., & Palmieri, F. (2023). Utility of Liver Biopsy in the Diagnosis and Management of Possible Drug-Induced Liver Injury in Patients Receiving Antituberculosis Therapy: A Retrospective Study. Infectious Disease Reports, 15(6), 735-746. https://doi.org/10.3390/idr15060066

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