Drug-Related Liver Injury

Question 1

how is drug-induced liver injury (DILI) defined?

Answer 1

• > 5 X ULN ALT
• > 2 X ALP
• > 3 X ALT + >2 X bilirubin

Question 2

what are the three patterns of DILI?

Answer 2

• hepatocellular
• cholestatic
• mixed

Question 3

what are the phenotypes of DILI?

Answer 3

• drug-induced autoimmune hepatitis
• checkpoint inhibitor-induced liver injury

Question 4

what classes of drugs may cause DILI?

Answer 4

• paracetamol
• NSAIDs
• anabolic steroids
• antibiotics
• oral contraceptives
• statins
• anticonvulsants

Question 5

what are the risk factors for DILI?

Answer 5

• pre-existing liver disease
• concurrent alcohol consumption + medication use
• long-acting/extended-release medications
• herbal supplements

Question 6

what are the long-term complications of DILI?

Answer 6

• fibrosis
• cirrhosis
• secondary sclerosing cholangitis
• portal hypertension
• chronic liver failure