Drug-induced liver injury can lead to changes of the biliary tree that resemble sclerosing cholangitis. These changes can be seen on magnetic resonance cholangiopancreatography. Idiosyncratic drug-induced liver injury (DILI) has a variable presentation including cholestatic liver injury, 1 in which case magnetic resonance imaging (MRI) is often performed to exclude pancreaticobiliary causes of obstruction. Sclerosing cholangitis (SC)–like changes on imaging have been described anecdotally with DILI. 2,3 A recent study of 25 consecutive, unselected DILI patients found that 10% had SC-like changes on magnetic resonance cholangiopancreatography (MRCP). 4 The aim of the current study was to identify the clinical features of patients enrolled in the U.S. Drug Induced Liver Injury Network (DILIN) prospective study who had SC-like changes on MRCP.
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