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Editorial
. 2024 Apr;18(2):384-419.
doi: 10.1007/s12072-023-10633-7. Epub 2024 Feb 24.

Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update

Yimin Mao  1 , Shiwu Ma  2 , Chenghai Liu  3 , Xiaoyan Liu  4 , Minghua Su  5 , Dongliang Li  6 , Yiling Li  7 , Gongying Chen  8 , Jun Chen  9 , Jinjun Chen  10 , Jingmin Zhao  11 , Xiaoyan Guo  12 , Jieting Tang  13 , Yuzheng Zhuge  14 , Qing Xie  15 , Wen Xie  16 , Rongtao Lai  15 , Dachuan Cai  17 , Qingxian Cai  9 , Yang Zhi  13 , Xiaoyun Li  13 ; Technology Committee on DILI Prevention, Management, Chinese Medical Biotechnology Association; Study Group on Drug-Induced Liver Disease, Chinese Society of Hepatology, Chinese Medical Association
Affiliations
Editorial

Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update

Yimin Mao et al. Hepatol Int. 2024 Apr.

Abstract

Drug-induced liver injury (DILI) is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases. Currently, the diagnosis of DILI still follows the strategy of exclusion. Therefore, a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis. This guideline was developed based on evidence-based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice. Based on the clinical settings in China, the guideline also specifically focused on DILI in chronic liver disease, drug-induced viral hepatitis reactivation, common causing agents of DILI (herbal and dietary supplements, anti-tuberculosis drugs, and antineoplastic drugs), and signal of DILI in clinical trials and its assessment.

Keywords: Diagnosis; Drug; Guideline; Herbal and dietary supplements; Liver injury; Management; Phenotypes; Prevention; Prognosis; Treatment.

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References

    1. Li X, Tang J, Mao Y. Incidence and risk factors of drug-induced liver injury. Liver Int. 2022;42:1999–2014 - PubMed - DOI
    1. Sgro C, Clinard F, Ouazir K, et al. Incidence of drug-induced hepatic injuries: a French population-based study. Hepatology. 2002;36:451–455 - PubMed - DOI
    1. Björnsson ES, Bergmann OM, Björnsson HK, Kvaran RB, Olafsson S. Incidence, presentation, and outcomes in patients with drug-induced liver injury in the general population of Iceland. Gastroenterology. 2013;144(7):1419–1425 - PubMed - DOI
    1. De Valle MB, Av Klinteberg V, Alem N, Olsson R, Björnsson E. Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic. Aliment Pharmacol Ther. 2006;24:1187–1195 - PubMed - DOI
    1. Andrade RJ, Lucena MI, Fernández MC, et al. Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Gastroenterology. 2005;129:512–521 - PubMed - DOI

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