Syndrome of intrahepatic cholestasis in patients with acute and chronic intoxication with pesticides

Abstract

Objective. To study the incidence and peculiarities of intrahepatic cholestasis (IHC) syndrome in patients with toxic liver damage in acute and chronic intoxications with pesticides and to substantiate rational methods of diagnosis and treatment. Material and methods. The incidence has been analysed with the description of IHC syndrome peculiarities in acute and remote periods in 238patients with acute poisoning with pesticides: 162 — herbicides based on 2,4-dichlorophenoxyacetic acid (2,4-D), 62 — phosphororganic pesticides (POP), 14 — synthetic pyrethroids (SP) and 70 — with chronic intoxication with pesticides (CIP). Clinical-instrumental, biochemical and statistical methods of the study have been used. Results and conclusions. Along with neurological disorders, the toxic liver damage was observed in 35,8 % of cases of acute poisoning with 2,4-D-based herbicides, in 51,6 % of cases — with POP poisoning, in 64,2 % of cases — with SP poisoning and in 84,2 % of cases — with CIP. IHC syndrome was detected in 22,8 % of cases in patients with pesticide intoxication against toxic hepatitis and in 18,0 % of cases — without signs of hepatitis. The therapeutic efficacy of ursodeoxycholic acid has been established when it is included in the combined therapy of patients with IHC upon intoxication with pesticides. Key words: pesticides, acute and chronic intoxications, toxic hepatitis, intrahepatic cholestasis syndrome, ursodeoxycholic acid.