title: Case Characterization, Clinical Features and Risk Factors in Drug-Induced Liver Injury.
abstract: Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals and dietary supplements) presents with a range of both phenotypes and severity, from acute hepatitis indistinguishable of viral hepatitis to autoimmune syndromes, steatosis or rare chronic vascular syndromes, and from asymptomatic liver test abnormalities to acute liver failure. DILI pathogenesis is complex, depending on the interaction of drug physicochemical properties and host factors. The awareness of risk factors for DILI is arising from the analysis of large databases of DILI cases included in Registries and Consortia networks around the world. These networks are also enabling in-depth phenotyping with the identification of predictors for severe outcome, including acute liver failure and mortality/liver transplantation. Genome wide association studies taking advantage of these large cohorts have identified several alleles from the major histocompatibility complex system indicating a fundamental role of the adaptive immune system in DILI pathogenesis. Correct case definition and characterization is crucial for appropriate phenotyping, which in turn will strengthen sample collection for genotypic and future biomarkers studies.
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Digestivas y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, 29071 Málaga, Spain. aida_ortega_alonso@hotmail.com.
authors.forename: Aida
authors.initials: A
authors.lastname: Ortega-Alonso
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Digestivas y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, 29071 Málaga, Spain. cstephens@uma.es.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain. cstephens@uma.es.
authors.forename: Camilla
authors.initials: C
authors.lastname: Stephens
authors.affiliation: Unidad de Gestión Clínica de Enfermedades Digestivas y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, 29071 Málaga, Spain. lucena@uma.es.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain. lucena@uma.es.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Lucena
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain. andrade@uma.es.
authors.forename: Raúl J
authors.initials: RJ
authors.lastname: Andrade
mesh_terms: D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male
keywords: DILI; drug-induced liver injury; risk factors