Table 4.

Histopathologic features of patients with Fenofibrate DILI

	Description
Case 1	Steatohepatitis with cholestasis and duct injury. Moderate macrovesicular steatosis in zone 3 associated with mild perisinusoidal fibrosis and small balloon cells. Also mild canalicular cholestasis. The portal areas are expanded with fibrosis and a mild infiltrate with occasional eosinophils. The ducts show injury without loss.
Case 4	Zone 3 cholestasis with mild portal and lobular inflammation, classified as an acute (bland) cholestasis. Eosinophils noted in portal areas. Duct injury present, but no duct loss and no chronic cholestatic features. No fibrosis.
Case 5	Initial biopsy with chronic cholestasis with prominent zone 3 bile accumulation and hepatocyte swelling. Features of chronic cholestasis included both pseudoxanthomatous change and copper accumulation. Duct injury was noted although there were no florid duct lesions or sclerotic lesions. Ducts appeared to be present in most of the portal areas. Inflammation is mild overall. Follow-up biopsies showed similar changes with some worsening of cholestatic features. The explant shows severe cholestasis in the parenchyma along with features of chronic cholestasis. There is no convincing duct paucity and no sclerosing lesions. Inflammation remained mild through the explant.
Case 6	Marked interface hepatitis with bridging necrosis and perivenular hepatitis with hepatocyte drop-out. Numerous foci of lobular inflammation. Plasma cells and eosinophils are prominent in the infiltrate. Duct injury is present, but more like Poulsen lesions than destructive injury. There were no features of chronic cholestasis and the copper stain was negative. There is both periportal and perivenular fibrosis without perisinusoidal fibrosis. Looks very much like autoimmune hepatitis.