title: Drug-Induced Liver Injury: Pattern Recognition and Future Directions.
abstract: Drug-induced liver injury (DILI) remains a significant clinical challenge and is the leading cause of acute liver failure in most countries. An aging population that uses more medications, a constant influx of newly developed drugs and a growing risk from unfamiliar herbal and dietary supplements will make DILI an increasing part of clinical practice. Currently, the most effective strategy for disease management is rapid identification, withholding the inciting agents, supportive care and having a firm understanding of the expected natural history. There are resources available to aid the clinician, including a new online "textbook" as well as causality assessment tools, but a heightened awareness of risk and the disease's varying phenotypes and good history-taking remain cornerstones to diagnosis. Looking ahead, growing registries of cases, pharmacoepidemiology studies and translational research into the mechanisms of injury may produce better diagnostic tools, markers for risk and disease, and prevention and therapeutics.
authors.affiliation: Department of Medicine and Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Tanvir
authors.initials: T
authors.lastname: Haque
authors.affiliation: Department of Pathology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Eizaburo
authors.initials: E
authors.lastname: Sasatomi
authors.affiliation: Department of Medicine and Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Hayashi
mesh_terms: D000367:Age Factors; D000890:Anti-Infective Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000453:epidemiology; D019587:Dietary Supplements / Q000009:adverse effects; D004365:Drugs, Chinese Herbal / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D015994:Incidence; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D004365:Drugs, Chinese Herbal; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014409:Tumor Necrosis Factor-alpha
keywords: Diagnosis; Drug induced liver injury; Epidemiology; Hepatotoxicity; Herbal and dietary supplements