s104.full.pdf (846.82 kB)
Drug-induced liver injury
Version 2 2023-06-12, 08:36
Version 1 2023-06-09, 04:31
journal contribution
posted on 2023-06-12, 08:36 authored by Dev Katarey, Sumita VermaSumita VermaDrug-induced liver injury (DILI) remains the most common cause of acute liver failure (ALF) in the western world. Excluding paractamol overdose, nearly all DILI encountered in the clinical setting is idiosyncratic in nature, since affected individuals represent only a small proportion of those treated with such drugs. In many cases the mechanism for idiosyncrasy is immune mediation and is often identified by genetic risk determined by HLA variants. In the absence of diagnostic tests and/or biomarkers, the diagnosis of DILI requires a high index of suspicion after diligently excluding other causes of abnormal liver tests. Antibiotics are the class of drugs most frequently associated with idiosyncratic DILI, though recent studies indicate that herbal and dietary supplements are an increasingly recognised cause. It is imperative that upon development of DILI the culprit drug be discontinued especially in the presence of elevated transaminases (AST/ALT =5ULN) and/or jaundice. Risk factors for the development ALF include hepatocellular DILI and female gender, the treatment being supportive with some benefit of N-acetylcysteine in early stages. In view of the poor transplant-free survival in idiosyncratic DILI, early consideration for liver transplant is mandatory.
History
Publication status
- Published
File Version
- Published version
Journal
Clinical MedicineISSN
1470-2118Publisher
Royal College of PhysiciansExternal DOI
Issue
Suppl6Volume
16Page range
104-109Department affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2017-01-03First Open Access (FOA) Date
2017-12-02First Compliant Deposit (FCD) Date
2016-12-25Usage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC