LAPAROSCOPIC APPEARANCE AND ITS HISTOLOGICAL FINDING IN DRUG INDUCED HYPERSENSITIVE LIVER INJURY

—CASES WITH MOSTLY SEVERE LIVER CELL NECROSIS—

Abstract

Laparoscopic appearance were studied in correlation to histological finding and clinical features in 20 cases with drug induced hypersensitive liver injury. We classfied into green liver and white one according to surface color of the liver. The surface of green liver showed smooth, and liver biopsy specimen appeared acute drug induced liver injury, combined type. Serum A1-p levels were significantly higher in green liver than in white one. The surface of white liver showed five types such as smooth (4 cases), groove like depression (2 cases), groove like depression+flat wavy deformity (1 case) and potato liver (1 case). Liver biopsy specimen of groove like depression appeared acute hepatocellular type. Liver biopsy specimen of groove like depression+flat wavy deformity, large regener-ative nodule and potato liver appeared chronic drug induced liver injury, hepatocellular type. In two cases multinucleated giant cells were seen around zonal liver cell necrosis. Severe liver cell necrosis was observed in two cases, who were detected serum autoantibodies. It suggests that the progress in some of the drug induced hypersensitive liver injury may involve an autoimmune mechanism.