Ground Glass-Like Inclusions: Associated with Liver Toxicity

Area of Science:

• Hepatology
• Cellular Pathology
• Toxicology

Background:

• Ground glass-like inclusions in hepatocytes have diverse etiologies, including viral infections and genetic disorders.
• Their association with immunosuppression and medications requires further clarification.
• This study investigates additional cases and unique etiologies of these inclusions.

Purpose of the Study:

• To explore the heterogeneous causes of ground glass-like inclusions in liver cells.
• To analyze clinical data and histological findings in patients with these inclusions.
• To determine the clinical significance and prognosis associated with ground glass-like inclusions.

Main Methods:

• Review of clinical data and histological slides from eleven cases (2008-2019).
• Exclusion of Hepatitis B virus, alcohol, and epilepsy as etiologies.
• Analysis of patient medication history and liver function tests.

Main Results:

• Mild lobular inflammation observed in 72% of cases.
• Ground glass-like hepatocytes showed varied distribution patterns.
• Medication use (NSAIDs, steroids, chemotherapy) was reported in 82% of patients; herbal toxicity in two.
• Elevated liver function tests were universal; four patients developed malignancy.
• Seven patients experienced resolution of elevated liver enzymes within a median of 37 months.

Conclusions:

• Medication is identified as the most significant etiology for ground glass-like inclusions.
• Herbal toxicity is also implicated as a potential cause.
• The inclusions generally follow an indolent course with resolution of transaminase elevation, and transplantation was not an identified factor.