A patient with drug-induced phospholipidosis may develop hepatic phospholipidosis. A careful drug history can be invaluable in identifying this condition.
Clinical features:
(1) history of exposure to a cationic amphiphilic drug
(2) granular or foamy hepatocytes and Kupffer cells
(3) relatively large numbers of Mallory hyaline bodies throughout the hepatic lobule, including the periportal areas
(4) variable steatosis
(5) fibrosis may develop over time which can progress to cirrhosis
Under electron microscopy the Mallory bodies are phospholipid-laden lysosomal lamellar bodies.
Most cases should eventually revert on discontinuation of the affecting drug unless irreversible hepatic injury has occurred.
