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Tests and diagnosis
By Mayo Clinic staffThere are no specific tests for toxic hepatitis. To diagnose toxic hepatitis, your doctor may do one or more of the following:
- Physical exam. Your doctor will likely perform a physical exam and take a complete medical history. Be sure to bring all medications you're taking, including over-the-counter drugs and herbs, in their original containers to your appointment. Tell your doctor if you work with industrial chemicals or may have been exposed to pesticides, herbicides or other environmental toxins such as polychlorinated biphenyls (PCBs).
- Blood tests. Your doctor may order blood tests that look for high levels of certain liver enzymes. These enzyme levels can show how well your liver is functioning.
- Liver biopsy. A liver biopsy can help confirm the diagnosis of toxic hepatitis. In a liver biopsy, a small sample of tissue is removed from your liver and examined under a microscope. Your doctor uses a thin needle to obtain the sample. Needle biopsies are relatively simple procedures requiring only local anesthesia. Risks include bruising, bleeding and infection.
If you're taking medications known to cause liver problems, your doctor may want to check your liver at least once every six months. Some types of liver damage can be reversed if treated promptly.
- Dienstag JL. Toxic and drug-induced hepatitis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Nov. 14, 2008.
- Lewis JH. Liver disease caused by anesthetics, toxins, and herbal preparations. In: Feldman M, et al. Sleisenger & Fordtran's Gastroinstestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/111481204-2/0/1389/0.html. Accessed Nov. 11, 2008.
- Friedman LS. Liver, biliary tract, & pancreas disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2009. 48th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Nov. 11, 2008.
- Brown JA. Haz-Map: Information on hazardous chemicals and occupational disease. National Institutes of Health. http://hazmap.nlm.nih.gov. Accessed Nov. 12, 2008.
- Fountain FF. Isoniazid hepatotoxicity associated with treatment of latent tuberculosis infection: A 7-year evaluation from a public health tuberculosis clinic. Chest. 2005;128:116.
- Fontana RJ. Acute liver failure including acetaminophen overdose. Medical Clinics of North America. 2008;92:761.
- Fontana RJ. Acute liver failure due to drugs. Seminars in Liver Disease. 2008;28:175.
- Watkins PB. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily. Journal of the American Medical Association. 2006;296:87.
- NCI drug dictionary. National Cancer Institute. http://www.cancer.gov/drugdictionary. Accessed Nov. 14, 2008.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Oct. 28, 2008.
