When Is Suspected Drug-Induced Liver Injury (DILI) Not DILI? An Analysis of Unlikely Cases From the Drug-Induced Liver Injury Network.


Journal

The American journal of gastroenterology
ISSN: 1572-0241
Titre abrégé: Am J Gastroenterol
Pays: United States
ID NLM: 0421030

Informations de publication

Date de publication:
01 12 2023
Historique:
received: 25 04 2023
accepted: 08 06 2023
medline: 4 12 2023
pubmed: 13 6 2023
entrez: 13 6 2023
Statut: ppublish

Résumé

Diagnosis of drug-induced liver injury (DILI) is difficult. We reviewed cases in the DILI Network prospective study that were adjudicated to have liver injury due to other causes to discover pearls for improved diagnostic accuracy. Cases were adjudicated by expert opinion and scored from 1 (definite DILI) to 5 (unlikely DILI). Confirmed cases (1-3) were compared with unlikely cases (5). One hundred thirty-four of the 1,916 cases (7%) were unlikely DILI. Alternative diagnoses were autoimmune hepatitis (20%), hepatitis C (20%), bile duct pathology (13%), and hepatitis E (8%). Thorough evaluation, including follow-up, is essential to minimize incorrect diagnosis of idiosyncratic DILI.

Identifiants

pubmed: 37311048
doi: 10.14309/ajg.0000000000002370
pii: 00000434-202312000-00036
doi:

Types de publication

Review Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

2301-2304

Subventions

Organisme : NIDDK NIH HHS
ID : U01 DK065211
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065184
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK065201
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK083020
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK083027
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK100928
Pays : United States
Organisme : NIDDK NIH HHS
ID : U24 DK065176
Pays : United States

Informations de copyright

Copyright © 2023 by The American College of Gastroenterology.

Références

Chalasani N, Bonkovsky HL, Fontana R, et al. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN prospective study. Gastroenterology 2015;148:1340–52.e7.
Barritt ASt, Lee J, Hayashi PH. Detective work in drug-induced liver injury: Sometimes it is all about interviewing the right witness. Clin Gastroenterol Hepatol 2010;8:635–7.
Rockey DC, Seeff LB, Rochon J, et al. Causality assessment in drug-induced liver injury using a structured expert opinion process: Comparison to the Roussel-UCLAF causality assessment method. Hepatology 2010;51:2117–26.
Ghabril M, Gu J, Yoder L, et al. Significant medical comorbidities are associated with lower causality scores in patients presenting with suspected drug-induced liver injury. Clin Transl Gastroenterol 2020;11:e00141.
Fontana RJ, Engle RE, Hayashi PH, et al. Incidence of hepatitis e infection in American patients with suspected drug-induced liver injury is low and declining: The DILIN prospective study. Am J Gastroenterol 2022;117:1462–70.
de Boer YS, Kosinski AS, Urban TJ, et al. Features of autoimmune hepatitis in patients with drug-induced liver injury. Clin Gastroenterol Hepatol 2017;15:103–12.e2.
Andrade RJ, Aithal GP, de Boer YS, et al. Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report. J Hepatol 2023. doi: 10.1016/j.jhep.2023.04.033. [Epub ahead of print.]
doi: 10.1016/j.jhep.2023.04.033
Mack CL, Adams D, Assis DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases. Hepatology 2020;72:671–722.
Björnsson E, Talwalkar J, Treeprasertsuk S, et al. Drug-induced autoimmune hepatitis: Clinical characteristics and prognosis. Hepatology 2010;51:2040–8.
Rochon J, Protiva P, Seeff LB, et al. Reliability of the Roussel UCLAF Causality Assessment Method for assessing causality in drug-induced liver injury. Hepatology 2008;48:1175–83.
Hayashi PH. Overview of causality assessment in drug-induced liver injury. Clin Liver Dis (Hoboken) 2017;9:29–33.
Asrani SK, Devarbhavi H, Eaton J, et al. Burden of liver diseases in the world. J Hepatol 2019;70:151–71.

Auteurs

A Sidney Barritt (AS)

UNC Liver Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

Huiman Barnhart (H)

Duke University, Durham, North Carolina, USA.

Jiezhun Gu (J)

Duke University, Durham, North Carolina, USA.

Andrew Dellinger (A)

Duke University, Durham, North Carolina, USA.

Sean Rudnick (S)

Wake Forest University School of Medicine & Atrium Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.

Herbert L Bonkovsky (HL)

Wake Forest University School of Medicine & Atrium Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.

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