Using cocaine can result in acute or chronic hepatotoxicity which can be severe. The cytochrome P-450 enzyme system has been implicated in the generation of toxic free radicals.
Clinical findings:
(1) acute or chronic hepatitis
(2) thrombotic microangiopathy
Histologic features:
(1) inflammation and necrosis may be periportal or centrizonal
(2) steatosis
Diagnostic features:
(1) the onset of liver disease after cocaine use
(2) recovery in liver function with discontinuation of cocaine use
(3) exclusion of other causes of hepatitis include ecstasy or other hepatotoxins
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