Abstract
Of 16,800 presumably well teenagers, 3181 were found to be drug abusters. Routine livr function tests in these latter patients revealed abnormalities in 1306, with SGPT elevation the most frequently noted. Forty patients, abnormal for 3 months, had a precutaneous liver biopsy. All specimens exhibited infiltration of the portal area and 75% showed hepatocyte necrosis. One half of the biopsies showed portal fibrosis. This degree of chronicity suggests that the usual course of viral hepatitis may be altered by the abuse of drugs. Alternatively, the drugs themselves may be directly responsible.
Guinea pig liver explants were grown in culture medium and shown to be metabolically active for 96 hours. Transaminase activity was assayed in the culture medium before addition of the explant and serially thereafter. Changes in enzyme activity were followed after the addition of substances commonly abused by teenagers, as well as CCl4.
The pattern of transaminase elevation at 24 hours by CCl4 provided the model fro acute toxicity. Other drugs tested showed no evidence of acute toxicity, nor did the addition of heroin to this system result int he transaminase elevation associated with acute toxicity.
This study suggests that heroin is not acutely hepatotoxic. The abnormalities of the liver noted in the heroin-using adolescents may be the result of a modifying effect on the usual course of viral hepatitis.
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Litt, I., Cohen, M., Schonberg, S. et al. Chronic active liver disease occurring in adolescents who use drugs: A study of possible etiologies. Pediatr Res 5, 391 (1971). https://doi.org/10.1203/00006450-197108000-00083
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DOI: https://doi.org/10.1203/00006450-197108000-00083