Toxic Hepatitis
Condition
(Drug-Induced Hepatitis)
Definition
Hepatitis is inflammation of the liver. Toxic hepatitis is when it happens due to medicine or exposure to toxic chemicals. It can be deadly without treatment.
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Causes
A major job of the liver is to process and break down foreign substances contained in the blood, including nutrients and chemicals. Some chemicals or drugs that are hard for the liver to process can damage it and cause inflammation.
Some substances linked to toxic hepatitis are:
- Medications:
- Acetaminophen
- Certain antibiotics
- Isoniazid—used to treat tuberculosis
- Halothane—general anesthetic
- Statins—for high cholesterol
- Methyldopa—for high blood pressure
- Gold compounds—for rheumatoid arthritis
- Herbs and dietary supplements:
- Comfrey
- Kava
- Mistletoe
- Certain combinations of traditional Chinese medical herbs
- High doses of vitamin A
- Certain dietary supplements for weight loss
- Chemicals:
- Alcohol
- Polychlorinated biphenyls
- Chloroform
- Phosphorous
- Dimethylformamide
- Carbon tetrachloride
Risk Factors
The way the liver processes drugs and chemicals varies from person to person. Not everyone will become sick from the same substance. But exposure to large amounts of one or more toxins can raise the risk of toxic hepatitis. People who drink excess alcohol or have liver disease are at increased risk when exposed.
Symptoms
Symptoms of toxic hepatitis are:
- Yellowing of the eyes and skin
- Nausea
- Vomiting
- Dark or brown-colored stools
- White or light-colored stools
- Lack of hunger
- Pain in the upper right part of the belly
- Dark or tea-colored urine
- Itching
Diagnosis
The doctor will ask about symptoms and past health. You will also be asked about your use of medicines and exposure to any chemicals. A physical exam will be done.
There is no specific test to diagnose every type of toxic hepatitis. A blood test will be done to check liver function. A sample of the liver may be taken for testing. This can be done with a biopsy.
Treatment
The goal of treatment is to stop inflammation of the liver before it causes permanent liver damage. The substance causing toxic hepatitis will need to be avoided or stopped. Symptoms usually go away in a few days or weeks once this is done. Emergency care may be needed to ease symptoms during this time.
People with severe liver damage may need a liver transplant .
Prevention
Exposure to toxic substances at work can be prevented by wearing protective clothing and gear. People who are at risk due to liver disease should check with their doctor for a list of medicines to avoid.
Agency for Toxic Substances and Disease Registry
Occupational Safety and Health Administration
CANADIAN RESOURCES:
Health Canada
Hepatitis C Caring Ambassadors Program
Agency for Toxic Substances and Disease Registry
Occupational Safety and Health Administration
CANADIAN RESOURCES:
Health Canada
Hepatitis C Caring Ambassadors Program
References
- Drug-induced liver injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/drug-induced-liver-injury.
- Liver injury caused by drugs. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/drugs-and-the-liver/liver-injury-caused-by-drugs.
- Toxic hepatitis. UCSF Health website. Available at: https://www.ucsfhealth.org/conditions/toxic-hepatitis.
Contributors
- David L. Horn, MD, FACP
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