Unbound MEDLINE

Drug-induced liver injury.

Abstract

PURPOSE OF REVIEW
Drug-induced liver injury (DILI) remains an important disease in clinical practice. It is difficult to predict, diagnose and manage. Studies in the peer-reviewed literature in the last 2 years, focusing on the diagnosis, prediction and management of DILI will be reviewed.
RECENT FINDINGS
Antibiotics remain the most common drug causing DILI in the United States and Europe. Expert opinion may still be the better method of diagnosing DILI compared with an objective tool such as the Roussel-Uclaf Causality Assessment Method. Hepatitis E represents an alternative diagnosis to some cases of presumed drug hepatotoxicity. There is ongoing research into the genetics of the pathophysiology and susceptibility of DILI. A genome-wide association study confirmed the association between human leukocyte antigen (HLA) class II and susceptibility to coamoxiclav (amoxicillin-clavulanic acid) induced DILI. There is new information on the protective effect of HLA-DRB1*07 family of alleles. MicroRNAs are a potential marker of DILI. Keratin variants may predict outcome of acute liver failure. N-acetylcysteine may be protective against DILI while taking antituberculosis medication.
SUMMARY
Recent findings in the genetics of pathophysiology and susceptibility of DILI can help with predicting and avoiding DILI in clinical practice and provide the foundation for ongoing research.

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  • Publisher Full Text
  • Authors

    Grant LM, Rockey DC

    Source

    Current opinion in gastroenterology 28:3 2012 May pg 198-202

    MeSH

    Acetylcysteine
    Amoxicillin-Potassium Clavulanate Combination
    Anti-Bacterial Agents
    Antitubercular Agents
    Disease Susceptibility
    Drug-Induced Liver Injury
    Europe
    Female
    Genome-Wide Association Study
    Genotype
    HLA-DRB1 Chains
    Humans
    Male
    Protective Agents
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22450893