Drug-induced liver injury: A clinical update

Marwan Ghabril, Naga Chalasani, Einar Björnsson

Research output: Contribution to journalReview articlepeer-review

80 Scopus citations


Purpose of Review: To gather new and important data published on idiosyncratic drug-induced liver injury (DILI) over the past 2 years in the peer-reviewed literature. Clinical studies focusing on mechanisms of injury, clinical evaluation and prognosis will be reviewed. Recent Findings: The most common drugs leading to DILI in the United States are antibiotics, central nervous system agents, herbal/dietary supplements and immunomodulatory agents. Hepatocellular type of DILI is more common in younger patients, whereas cholestatic pattern increases with older age. Certain human leukocyte antigen genotype increases the likelihood of flucloxacillin-induced liver injury. Idiosyncratic DILI was shown to have an important dose-dependency and drugs with extensive hepatic metabolism are associated with higher frequency of DILI. Chronic DILI may occur, but development of clinically important liver injury after severe DILI is rare. N-acetylcysteine seems to be beneficial for patients with acute liver failure caused by medications or herbal agents.

Original languageEnglish (US)
Pages (from-to)222-226
Number of pages5
JournalCurrent Opinion in Gastroenterology
Issue number3
StatePublished - May 2010


  • Diagnosis
  • Drug-induced liver injury
  • Hepatotoxicity
  • Natural history

ASJC Scopus subject areas

  • Gastroenterology

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