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
Chalasani NP, et al. ACG clinical guideline: the diagnosis and management of idiosyncratic drug-induced liver injury. Am J Gastroenterol. 2014;109:950–66.
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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Stravitz RT, et al. Autoimmune acute liver failure: proposed clinical and histological criteria. Hepatology. 2011;53:517–26.
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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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