title: CSH guidelines for the diagnosis and treatment of drug-induced liver injury.
abstract: Drug-induced liver injury (DILI) is an important clinical problem, which has received more attention in recent decades. It can be induced by small chemical molecules, biological agents, traditional Chinese medicines (TCM), natural medicines (NM), health products (HP), and dietary supplements (DS). Idiosyncratic DILI is far more common than intrinsic DILI clinically and can be classified into hepatocellular injury, cholestatic injury, hepatocellular-cholestatic mixed injury, and vascular injury based on the types of injured target cells. The CSH guidelines summarized the epidemiology, pathogenesis, pathology, and clinical manifestation and gives 16 evidence-based recommendations on diagnosis, differential diagnosis, treatment, and prevention of DILI.
authors.affiliation: Liver Disease Center of PLA, Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, 210002, China.
authors.forename: Yue-Cheng
authors.identifier: http://orcid.org/0000-0003-3480-1829
authors.initials: YC
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, China. maoym11968@163.com.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Mao
authors.affiliation: Shanghai Liver Diseases Research Center, 85th Hospital, Nanjing Military Command, Shanghai, 200235, China. ccw2@163.com.
authors.forename: Cheng-Wei
authors.initials: CW
authors.lastname: Chen
authors.affiliation: Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
authors.forename: Jin-Jun
authors.initials: JJ
authors.lastname: Chen
authors.affiliation: Liver Diseases Center, Second Xiangya Hospital, Central South University, Changsha, 410011, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, 201805, China.
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Cong
authors.affiliation: Department of Infectious Disease, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Ding
authors.affiliation: Artificial Liver Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
authors.forename: Zhong-Ping
authors.initials: ZP
authors.lastname: Duan
authors.affiliation: Shanghai Liver Diseases Research Center, 85th Hospital, Nanjing Military Command, Shanghai, 200235, China.
authors.forename: Qing-Chun
authors.initials: QC
authors.lastname: Fu
authors.affiliation: Department of Gastroenterology, Second Affiliated Hospital, Xi'an Jiaotong University, Xian, 710004, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Guo
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Hu
authors.affiliation: Department of Pathology, School of Medicine, Fudan University, Shanghai, 200433, China.
authors.forename: Xi-Qi
authors.initials: XQ
authors.lastname: Hu
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medial University, Beijing, 100069, China.
authors.forename: Ji-Dong
authors.initials: JD
authors.lastname: Jia
authors.affiliation: Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
authors.forename: Rong-Tao
authors.initials: RT
authors.lastname: Lai
authors.affiliation: Department of Hepatobiliary Disease, Fuzhou General Hospital of PLA, Fuzhou, 350025, China.
authors.forename: Dong-Liang
authors.initials: DL
authors.lastname: Li
authors.affiliation: Department of Liver Disease, Shenzhen Third People's Hospital, Shenzhen, 518040, China.
authors.forename: Ying-Xia
authors.initials: YX
authors.lastname: Liu
authors.affiliation: Department of Gastroenterology, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200080, China.
authors.forename: Lun-Gen
authors.initials: LG
authors.lastname: Lu
authors.affiliation: Department of Infectious Diseases, Kunming General Hospital of PLA, Kunming, 650032, China.
authors.forename: Shi-Wu
authors.initials: SW
authors.lastname: Ma
authors.affiliation: Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, China.
authors.forename: Xiong
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Traditional and Western Medical Hepatology, Third Affiliated Hospital, Hebei Medical University, Shijiazhuang, 050051, China.
authors.forename: Yue-Min
authors.initials: YM
authors.lastname: Nan
authors.affiliation: Department of Infectious Diseases, Institute for Viral Hepatitis, Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ren
authors.affiliation: Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing University, Beijing, 100083, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Shen
authors.affiliation: Institute of Hepatology, People's Hospital, Beijing University, Beijing, 100044, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Zhongshan Hospital, School of Medicine, Fudan University, Shanghai, 200032, China.
authors.forename: Ji-Yao
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Department of Pathology, China-Japan Friendship Hospital, Capital Medical University, Beijing, 100029, China.
authors.forename: Tai-Ling
authors.initials: TL
authors.lastname: Wang
authors.affiliation: Shanghai Liver Diseases Research Center, 85th Hospital, Nanjing Military Command, Shanghai, 200235, China.
authors.forename: Xiao-Jin
authors.initials: XJ
authors.lastname: Wang
authors.affiliation: Institute of Hepatology, People's Hospital, Beijing University, Beijing, 100044, China.
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100011, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Xie
authors.affiliation: Department of Gastroenterology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065c, China.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Yang
authors.affiliation: Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Dong-Liang
authors.initials: DL
authors.lastname: Yang
authors.affiliation: Department of Infectious Disease, Beijing University First Hospital, Beijing, 100034, China.
authors.forename: Yan-Yan
authors.initials: YY
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, China.
authors.forename: Min-de
authors.initials: MD
authors.lastname: Zeng
authors.affiliation: Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078c, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Liver Research Center, Beijing Friendship Hospital, Capital Medial University, Beijing, 100069, China.
authors.forename: Xin-Yan
authors.initials: XY
authors.lastname: Zhao
authors.affiliation: Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing University, Beijing, 100083, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhuang
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000633:toxicity; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000633:toxicity; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D002681:China / Q000453:epidemiology; D002779:Cholestasis / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D003937:Diagnosis, Differential; D019587:Dietary Supplements / Q000009:adverse effects* / Q000633:toxicity; D004365:Drugs, Chinese Herbal / Q000009:adverse effects; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D004365:Drugs, Chinese Herbal
keywords: Clinical type; Diagnosis; Differential diagnosis; Drug-induced liver injury; Epidemiology; Pathogenesis; Pathology; Prevention; Recommendations; Treatment