[The diagnosis of drug-induced hepatopathies]

The present paper reports on the recent possibilities of diagnosis in iatrogenic diseases of the liver. The iatrogenic diseases of the liver are diagnosed with difficulty since no clinical, biological and histological pathognomonic criteria are known. The hepatic lesions appearing after drug intake are extremely various, including: hepatocellular necrosis, cholestasis, hepatic granuloma, perisinusoid fibrosis, steatosis, pseudoalcoholic lesions, vascular lesions and hepatic tumours. Clinical criteria, very important for the diagnosis, are based on: appearance of the disease, regression of symptomatology when the treatment is interrupted and recurrence when it is administered again. The biological criteria are not specific but they may indicate the drug etiology of a liver disease. Increase in the serum concentration of aminotransferases might be the only biochemical disturbance and it might be overlooked if not systematically investigated. The immunological tests suggested for diagnosis of iatrogenic liver diseases are numerous but only a few of them are specific. Histological criteria cannot identify, for sure, the drug etiology of the lesions. They may suggest the possibility of a drug induced cause and may help in establishment of a correct diagnosis.