Histopathological Patterns in Drug-Induced Liver Injury

Histopathological Patterns in Drug-Induced Liver Injury: Analysis of 63 CasesABSTRACTObjective: This study aimed to evaluate the histopathological findings and injury patterns in liver biopsies from patients with suspected drug-induced liver injury (DILI).Materials and Methods: Sixty-three patients undergoing core needle liver biopsy for suspected DILI were retrospectively reviewed. Biopsies were evaluated with H-E and special stains; HAI and fibrosis stage were scored using the Ishak system. Injury patterns were classified as hepatitic, cholestatic, centrilobular, AIH-like and mixed type.Results: Forty-five patients (71.4%) were female; mean age was 45.9 ± 13.8 years. Hepatitic-type injury was most frequent (68.3%), followed by mixed (17.5%) and cholestatic types (9.5%). Mean HAI score was 8.1 ± 2.4; fibrosis stage 2 was most common (42.9%). Eosinophilic infiltration was present in 81.0%, plasma cell infiltration was observed in 44.4% of cases. HAI score and fibrosis stage differed significantly between groups (p=0.015 and p=0.006, respectively).Conclusion: The histopathological spectrum of presumed DILI is heterogeneous. Eosinophilic infiltration and plasma cell infiltration are key diagnostic clues for clinicopathological correlation. This series contributes a morphological framework for DILI evaluation in a Turkish patient cohort.Keywords: Drug-induced liver injury; hepatotoxicity; histopathology; injury pattern; Ishak scoring system