Affiliation:
1. St. Petersburg State Pediatric Medical University
2. St. Petersburg State Chemical Pharmaceutical University
3. City polyclinic No. 28
Abstract
The review article discusses modern aspects of drug-induced liver injury (DILI) in patients with tuberculosis who are receiving etiotropic therapy. The main mechanisms of DILI, including toxic and idiosyncratic types, are described, as well as their pathogenetic, biochemical, and epidemiological differences. DILI can manifest as various clinicomorphological forms of liver damage, such as steatosis and steatohepatitis, acute and chronic hepatitis, mitochondrial cytopathy, cholestasis, sclerosing cholangitis, vascular injury, and others. The main diagnostic method for DILI is the detection of liver enzymes - transaminases and alkaline phosphatase - based on the degree of elevation and their ratio, which identify two main types of liver injury - hepatocellular and cholestatic - as well as a mixed variant. The article provides a scoring assessment of liver damage in a patient receiving chemotherapy to classify it as drug-induced liver injury.
Publisher
Scientia Publishing House LTD
Reference112 articles.
1. Туберкулез у взрослых: клинические рекомендации. Российское общество фтизиатров, 2021. 135 с.
2. Мельдеханов Т.Т., Куттыбаев А.Д., Иманбекова Ж.А., Терликбаева Г.А. Токсические лекарственные поражения печени // Вестник КазНМУ. 2019. № 1. С. 63-66. EDN: NDSHWQ.
3. Стаценко М.Е., Туркина С.В., Тыщенко И.А. Клиника и диагностика лекарственных поражений печени: обзор новых рекомендаций // Лекарственный вестник. 2019. Т. 13. №. 2. С. 3-9. EDN: ZIMNCQ.
4. Демидова О.А., Архипов В.В., Журавлева М.В., и др. Безопасность лекарственных растительных препаратов: клинико-фармакологические аспекты // Безопасность и риск фармакотерапии. 2020. № 4. С. 165-177. DOI: 10.30895/2312-7821-2020-8-4-165-177. EDN: XJVGUU.
5. Казюлин А.Н., Вельшер Л.З., Королева И.А. Проблемы гепатотоксичности при проведении противоопухолевой химиотерапии онкологических заболеваний и методы ее коррекции // Фарматека. 2010. № 17(211). С. 82-90. EDN: NCCTJJ.