Drug induced liver injury: Pathogenesis, clinical features and monitoring

Abstract

Introduction: Drug-induced liver injury (DILI) is a rare but potentially life threatening adverse drug reactions. DILI may mimic pathophysiology or histopathologic features of an acute or chronic liver disease, and they may be indistinguishable from those of other causes of liver injuries. Liver can be affected directly, in a dose-dependent manner, or idiosyncratically, independently of the dose, and therefore unpredictably developed. Methods: In this special article we provided results given in the articles published in PubMed in the period 2006-2016. The search was made based on the most frequent reported drugs inducing liver injuries, diagnostic assessment, monitoring and outcomes of DILI. Results: The true incidence of DILI still remains unknown but the incidence of up to 14 cases per 100,000 inhabitants/year has been most frequently reported. Antimicrobial agents, analgesics, hipolipemics and antiepileptics are the most common drugs causing DILI. Conclusion: Although several biomarkers have been found through analytical tests, none of them have been able to display enough specificity and sensitivity in DILI diagnosis. Therefore, diagnostic assessment of DILI is still based on clinical examination, pharmacological treatment history, current RUCAM criteria, and liver function laboratory test.

Keywords

• drugs
• hepatotoxicity
• idiosyncrasies
• pharmacogenetics
• rucam criteria