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Drug-induced liver injury.

Publication ,  Journal Article
Andrade, RJ; Chalasani, N; Björnsson, ES; Suzuki, A; Kullak-Ublick, GA; Watkins, PB; Devarbhavi, H; Merz, M; Lucena, MI; Kaplowitz, N; Aithal, GP
Published in: Nat Rev Dis Primers
August 22, 2019

Drug-induced liver injury (DILI) is an adverse reaction to drugs or other xenobiotics that occurs either as a predictable event when an individual is exposed to toxic doses of some compounds or as an unpredictable event with many drugs in common use. Drugs can be harmful to the liver in susceptible individuals owing to genetic and environmental risk factors. These risk factors modify hepatic metabolism and excretion of the DILI-causative agent leading to cellular stress, cell death, activation of an adaptive immune response and a failure to adapt, with progression to overt liver injury. Idiosyncratic DILI is a relative rare hepatic disorder but can be severe and, in some cases, fatal, presenting with a variety of phenotypes, which mimic other hepatic diseases. The diagnosis of DILI relies on the exclusion of other aetiologies of liver disease as specific biomarkers are still lacking. Clinical scales such as CIOMS/RUCAM can support the diagnostic process but need refinement. A number of clinical variables, validated in prospective cohorts, can be used to predict a more severe DILI outcome. Although no pharmacological therapy has been adequately tested in randomized clinical trials, corticosteroids can be useful, particularly in the emergent form of DILI related to immune-checkpoint inhibitors in patients with cancer.

Duke Scholars

Published In

Nat Rev Dis Primers

DOI

EISSN

2056-676X

Publication Date

August 22, 2019

Volume

5

Issue

1

Start / End Page

58

Location

England

Related Subject Headings

  • Risk Factors
  • Humans
  • Chemical and Drug Induced Liver Injury
  • Biopsy
  • Biomarkers
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Andrade, R. J., Chalasani, N., Björnsson, E. S., Suzuki, A., Kullak-Ublick, G. A., Watkins, P. B., … Aithal, G. P. (2019). Drug-induced liver injury. Nat Rev Dis Primers, 5(1), 58. https://doi.org/10.1038/s41572-019-0105-0

Published In

Nat Rev Dis Primers

DOI

EISSN

2056-676X

Publication Date

August 22, 2019

Volume

5

Issue

1

Start / End Page

58

Location

England

Related Subject Headings

  • Risk Factors
  • Humans
  • Chemical and Drug Induced Liver Injury
  • Biopsy
  • Biomarkers
  • 3202 Clinical sciences
  • 1103 Clinical Sciences