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Drug-Induced Liver Injury

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Liver Disease

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Abstract

Drug-induced liver injury (DILI) accounts for about 50% of acute liver failure cases in the United States. Diagnosis is challenging, especially due to the myriad combinations of potentially hepatotoxic medications and clinical presentations. Unexplained liver injury should prompt a thorough investigation of medication administration (e.g., for accidental or intentional overdose) and the use of herbal and dietary supplements. The framework for approaching DILI includes the following: (1) categorize the injury as either intrinsic or idiosyncratic, (2) establish time course and pattern of injury, and (3) triage effectively to minimize mortality risk.

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Further Reading

  1. Chalasani NP, et al. ACG clinical guideline: the diagnosis and management of idiosyncratic drug-induced liver injury. Am J Gastroenterol. 2014;109:950–66.

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  2. Kwo PY, Cohen SM, Lim JK. ACG practice guideline: evaluation of abnormal liver chemistries. Am J Gastroenterol. 2017;112(1):18–35.

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  3. Lee WM. Drug-induced hepatotoxicity. NEJM. 2003;349:474–85.

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  4. Lee WM, Stravitz RT, Larson AM. Revised American Association for the Study of Liver Diseases position paper on acute liver failure. Hepatology. 2012;55(3):965–7.

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  5. Reuben A, Koch DG, Lee WM. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Hepatology. 2010;52:2065–76.

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  6. Stravitz RT, et al. Autoimmune acute liver failure: proposed clinical and histological criteria. Hepatology. 2011;53:517–26.

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Author information

Authors and Affiliations

  1. Section of Digestive Diseases, Department of Medicine, Yale-New Haven Hospital, New Haven, CT, USA

    Dennis L. Shung

  2. Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA

    Joseph K. Lim

Authors
  1. Dennis L. Shung
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  2. Joseph K. Lim
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Correspondence to Joseph K. Lim .

Editor information

Editors and Affiliations

  1. Case Western Reserve University, School of Medicine, University Hospitals of Cleveland, Cleveland, OH, USA

    Stanley Martin Cohen

  2. Case Western Reserve University, University Hospitals of Cleveland, Cleveland, OH, USA

    Perica Davitkov

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© 2019 Springer Nature Switzerland AG

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Shung, D.L., Lim, J.K. (2019). Drug-Induced Liver Injury. In: Cohen, S., Davitkov, P. (eds) Liver Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-98506-0_1

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  • DOI: https://doi.org/10.1007/978-3-319-98506-0_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98505-3

  • Online ISBN: 978-3-319-98506-0

  • eBook Packages: MedicineMedicine (R0)

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