Objective To investigate the causes of misdiagnosis and preventive measures of hepatic fibrosis caused by drug-induced liver injury(DILI).Methods The clinical data of 15 misdiagnosed patients with DILI-induced liver fibrosis admitted from May 2020 to December 2022 were retrospectively analyzed.Results Among the 15 patients,there was fever accompanied by cough in 1 patient,fever accompanied by frequent urination,urgent urination and pain in 2 patients,skin pruritus and urticaria in 3 patients,muscle soreness and joint pain in 2 patients,loss of appetite,fatigue,nausea,diarrhea,and upper abdominal discomfort in 7 patients.There was slight scleral yellow staining in 4 patients,the enlarged lymph nodes palpated on the left submaxillary side without adhesion to the surrounding tissues and mild tenderness in 1 patient.On auscul-tation,there was 1 patient with reduced respiratory sound,and no obvious moist rales were heard.There was mild to moderate tenderness in upper abdomen in 7 patients,joint pain with stiffness in the morning in 1 patient,and limited mobility of the waist and hip joints in 1 patient.The preliminary diagnosis was pulmonary infection(n=1),rheumatoid arthritis(n=1),an-kylosing spondylitis(n=1),urinary tract infection(n=2),allergic rash(n=3)and gastroenteritis(n=7).All 15 pa-tients were diagnosed as liver fibrosis caused by DILI after completing relevant examination and confirming the history of medi-cation.The misdiagnosis lasted 2-7 d.After diagnosis,the suspected drugs were withdrawn immediately,and aggressive symptomatic and biological infrared therapy was given,and the symptoms of the patient were relieved.At 6 months after fol-low-up,the degree of liver fibrosis improved.Conclusion The onset of DILI is occult,and its clinical manifestations are di-verse and lack of specificity,which are more likely to lead to misdiagnosis.Clinicians should improve their ability of clinical identification of DILI to reduce or avoid misdiagnosis.
维普
万方数据