Drug-induced liver injury. Part I: Classification, diagnosis and treatment.

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Experimental Hepatology Pub Date : 2025-03-01 Epub Date: 2025-03-25 DOI:10.5114/ceh.2025.148329
Dorota M Kozielewicz, Piotr Stalke, Julita Skrzypek
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引用次数: 0

Abstract

Drug-induced liver injury (DILI) is a growing clinical problem. Antibiotics remain the most common cause of DILI in Europe. Their clinical spectrum is very broad, from asymptomatic to acute liver failure. Currently, DILI is categorized as hepatocellular (R ≥ 5), cholestatic (R ≤ 2) or mixed (R = 2-5) injury based on the serum alanine aminotransferase (ALT)/alkaline phosphatase (ALP) ratio. DILI is a diagnosis of exclusion and requires a wide differential diagnosis. The most important step in management is discontinuation of the drug suspected of causing liver damage. The list of specific antidotes that eliminate the effects of hepatotoxins is unfortunately very short. In symptomatic treatment, glucocorticosteroids and ursodeoxycholic acid have been used in selected cases. Liver transplantation is an optional treatment in patients with acute liver failure.

药物性肝损伤。第一部分:分类、诊断和治疗。
药物性肝损伤(DILI)是一个日益突出的临床问题。抗生素仍然是欧洲DILI最常见的原因。他们的临床范围很广,从无症状到急性肝功能衰竭。目前,根据血清谷丙转氨酶(ALT)/碱性磷酸酶(ALP)比值,DILI可分为肝细胞性(R≥5)、胆汁淤积性(R≤2)或混合性(R = 2-5)损伤。DILI是一种排除诊断,需要广泛的鉴别诊断。治疗中最重要的一步是停药,怀疑引起肝损害。不幸的是,能够消除肝毒素影响的特定解毒剂很少。在对症治疗中,糖皮质激素和熊去氧胆酸已在选定的病例中使用。肝移植是急性肝衰竭患者的一种可选治疗方法。
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来源期刊
Clinical and Experimental Hepatology
Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
0.00%
发文量
32
期刊介绍: Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.
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