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Drug-Induced Liver Injury

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A spectrum of clinical liver diseases ranging from mild biochemical abnormalities to ACUTE LIVER FAILURE, caused by drugs, drug metabolites, and chemicals from the environment.

Also Known As:

Drug-Induced Liver Disease; Hepatitis, Drug-Induced; Hepatitis, Toxic; Toxic Hepatitis; Disease, Drug-Induced Liver; Diseases, Drug-Induced Liver; Drug Induced Liver Disease; Drug Induced Liver Injury; Drug-Induced Hepatitides; Drug-Induced Hepatitis; Drug-Induced Liver Diseases; Drug-Induced Liver Injuries; Hepatitides, Drug-Induced; Hepatitides, Toxic; Hepatitis, Drug Induced; Injuries, Drug-Induced Liver; Injury, Drug-Induced Liver; Liver Disease, Drug-Induced; Liver Diseases, Drug-Induced; Liver Injuries, Drug-Induced; Liver Injury, Drug Induced; Toxic Hepatitides; Liver Injury, Drug-Induced

Networked: 1227 relevant articles (31 outcomes, 70 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Tuberculosis (Tuberculoses)
2.	Hepatitis
3.	Pruritus (Itching)
4.	Biliary Liver Cirrhosis (Primary Biliary Cirrhosis)
5.	Drug Toxicity (Drug Safety)

Experts

1.	Fontana, Robert J: 20 articles (09/2015 - 11/2007)
2.	Watkins, Paul B: 19 articles (11/2015 - 01/2005)
3.	Yokoi, Tsuyoshi: 16 articles (01/2016 - 10/2009)
4.	Nakajima, Miki: 14 articles (02/2015 - 10/2009)
5.	Fukami, Tatsuki: 12 articles (02/2015 - 10/2009)
6.	Chalasani, Naga: 11 articles (11/2015 - 01/2009)
7.	Andrade, Raúl J: 10 articles (08/2015 - 12/2003)
8.	Tsuneyama, Koichi: 10 articles (02/2015 - 10/2009)
9.	Popova, T N: 10 articles (07/2010 - 04/2004)
10.	Bonkovsky, Herbert L: 9 articles (06/2015 - 01/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Drug-Induced Liver Injury:

1.	Acetaminophen (Paracetamol)FDA LinkGeneric 10/01/2008 - "We have demonstrated previously that acetaminophen activates Nrf2 in mouse liver following administration of non-hepatotoxic and hepatotoxic doses in vivo, implying that Nrf2 may have an important role in the protection against drug-induced liver injury. " 02/01/2013 - "Recent studies have provided important information in the field of drug-induced liver injury (DILI), in particular regarding the pathogenesis of acetaminophen hepatotoxicity. " 01/01/2015 - "The diagnosis of drug-induced liver injury (DILI) is largely a diagnosis of exclusion because, with the possible exception of protein:drug adducts in paracetamol overdose, there are no laboratory, biopsy or imaging tests that alone are capable of establishing an unequivocal diagnosis of DILI. " 01/01/2015 - "We will conduct a systematic review of the benefit and harm of NAC in non-paracetamol drug-induced liver injury. " 01/01/2015 - "More recently, research has explored the use of NAC in non-paracetamol drug-induced liver injury. "
2.	EnzymesIBA 01/01/2014 - "This study evaluated whether the polymorphisms in these enzymes were associated with an increased risk of anti-TB drug-induced hepatitis in patients and could potentially be used to identify patients at risk of liver injury. " 11/01/2009 - "This study aimed to investigate the association of genetic polymorphisms in drug-metabolizing enzymes with anti-TB drug-induced hepatitis. " 12/01/1995 - "Tests capable of quantitating the activities of specific relevant enzymes have been recently developed and are now being applied in clinical trials to assess risk factors for drug-induced liver disease. " 01/01/1961 - "[Contribution to the study of some energetic enzymes during experimental chronic toxic hepatitis]." 03/01/2015 - "Anti-TB drug-induced liver injury (ATLI) was assessed based on liver enzymes following the criteria of American Thoracic Society. "
3.	Isoniazid (Ftivazide)FDA LinkGeneric 04/01/2014 - "Idiosyncratic drug-induced liver injury (DILI) is a significant adverse effect of antitubercular therapy with isoniazid (INH). " 08/01/2011 - "Reintroduction of a drug suspected to cause drug-induced liver injury is generally not recommended; however, our experience suggests that isoniazid, a first-line antituberculosis drug, may be reintroduced after desensitization." 05/01/2011 - "The treatment with isoniazid was abandoned by 1 patient (2.2%) and completed by 41 (91.2%), whereas it was interrupted because of drug-induced hepatitis in 2 (4.4%), and 1 patient (2.2%) was transferred to another hospital. " 08/15/2004 - "Three patients developed drug-induced hepatitis--all were taking isoniazid. " 04/01/2003 - "Most cases with antituberculosis drug-induced hepatitis have been attributed to isoniazid. "
4.	Glutathione (Reduced Glutathione)IBA 01/01/2011 - "Protective effects of exogenous glutathione and related thiol compounds against drug-induced liver injury." 08/27/2012 - "We present a rare case of drug induced hepatitis secondary to herbal medications used to treat HIV and elucidate the role of glutathione depletion in immunocompromised patients." 08/27/2012 - "A rare cause of drug-induced hepatitis in an immunocompromised patient and the role of glutathione." 09/01/2010 - "Glutathione (GSH) levels are modulated in human liver slices to evaluate if drug induced liver injury is enhanced by a poor liver GSH status. " 02/15/2009 - "Drug-induced liver injury has been associated with the generation of reactive metabolites, which are primarily detoxified via glutathione conjugation. "
5.	Alanine Transaminase (SGPT)IBA 04/01/2013 - "Although alanine aminotransferase (ALT) remains the gold standard biomarker of liver injury, alternative biomarker strategies to better predict the potential for severe drug-induced liver injury (DILI) are essential. " 11/07/2012 - "To identify the proportion, causes and the nature of drug-induced liver injury (DILI) in patients with notably elevated alanine aminotransferase (ALT). " 11/07/2012 - "Drug-induced liver injury in hospitalized patients with notably elevated alanine aminotransferase." 08/01/2012 - "Drug induced liver injury during drug development is evidenced by a higher incidence of serum alanine aminotransferase (ALT) elevations in treated versus placebo populations and termed an "ALT signal". " 04/01/2010 - "Enhancing the utility of alanine aminotransferase as a reference standard biomarker for drug-induced liver injury."
6.	Rifampin (Rifampicin)FDA LinkGeneric 04/01/1999 - "[Acute renal failure, intravascular hemolysis and toxic hepatitis caused by repeated use of rifampicin (case report)]." 04/01/1999 - "We report the case of a 57-year-old man treated with interrupted rifampicin therapy for urinary tract tuberculosis who experienced acute renal failure, intravascular hemolysis and toxic hepatitis. " 01/01/2011 - "Pharmacogenetic & pharmacokinetic biomarker for efavirenz based ARV and rifampicin based anti-TB drug induced liver injury in TB-HIV infected patients." 04/01/1996 - "After resolution of drug induced hepatitis, reintroduction of isoniazid and rifampicin was possible in 41 of 44 patients. " 10/01/1994 - "[A case of allergic drug-induced hepatitis suspected with rifampicin-induced antinuclear antibody]."
7.	Biological Markers (Surrogate Marker)IBA 02/01/2013 - "Recent studies using metabolomics to understand PPARα function, as well as to identify PPARα biomarkers associated with drug efficacy/toxicity and drug-induced liver injury, will be discussed." 01/01/2013 - "Biomarkers of drug-induced liver injury (DILI) are essential for the diagnosis of severe cases of DILI in clinical trials and clinical practice, but the currently used biomarker paradigm detects damage after it has occurred and has limited prognostic value. " 08/01/2012 - "The Liver Toxicity Biomarker Study is a systems toxicology approach to discover biomarkers that are indicative of a drug's potential to cause human idiosyncratic drug-induced liver injury. " 03/20/2008 - "Since these biomarkers are found in the serum/plasma of treated humans and rats, they have potential to be utilized as bridging markers to monitor acute drug-induced liver injury in early clinical trials." 01/22/2016 - "A novel cell-based assay for the evaluation of immune- and inflammatory-related gene expression as biomarkers for the risk assessment of drug-induced liver injury."
8.	Ursodeoxycholic Acid (Urso)FDA LinkGeneric 01/01/2001 - "In this study the effect of ursodeoxycholic acid on liver regeneration was investigated using the animal model of toxic hepatitis induced by anticonvulsive drug depackin, which is employed in infant neurology. " 11/01/1996 - "Potential utility of ursodeoxycholic acid administration in toxic hepatitis." 05/01/2006 - "The authors address some of the more controversial aspects in relation to drug-induced liver injury: recommendations on the use of anti-tuberculosis therapy in the presence of underlying cirrhosis, the role of periodic liver test monitoring and steroid therapy in relation to drug-induced liver injury, the presence of class effects associated with certain drugs, and the potential use of ursodeoxycholic acid in prolonged cholestasis." 06/01/2004 - "Ursodeoxycholic acid for terbinafine-induced toxic hepatitis." 05/01/2002 - "For other drug-induced liver diseases characterised by a prolonged course, therapy with ursodeoxycholic acid or steroids may be helpful. "
9.	BilirubinIBA 01/01/2013 - "No studies have so far sufficiently investigated the risk factors for drug-induced liver injury (DILI) with an elevated serum bilirubin concentration. " 01/01/2014 - "Anti-TB drug-induced liver injury (ATLI) was defined as an ALT, AST or bilirubin value more than twice the upper limit of normal. " 11/01/2010 - "A subset of these patients, having normal hepatic function (n = 218, mean age 39.5 years), was studied in greater detail to eliminate the possible confounding effects of any underlying or drug-induced liver disease on the serum bilirubin levels. " 03/01/2004 - "Drug-induced liver injury (DILI) is the elevation of liver enzyme and/or bilirubin levels caused by the use of a medication or drug. " 08/01/2002 - "Age >60 years, abnormal baseline transaminase/bilirubin levels and female sex were risk factors associated with the development of TB drug-induced hepatitis."
10.	SilymarinIBA 01/01/2015 - "A double-blinded randomized controlled trial of silymarin for the prevention of antituberculosis drug-induced liver injury." 01/01/2015 - "We aimed to evaluate the efficacy of silymarin for preventing antituberculosis-drug induced liver injury (antiTB-DILI) in patients with tuberculosis. " 12/01/2004 - "The article presents the findings of the study of Legalon influence on detoxic, protein-synthesizing liver function, the resistance of hepatocytes in patients with steatohepatitis, chronic toxic hepatitis, chronic viral hepatitis C with minimal activity and liver cirrhosis. " 11/01/2006 - "Silymarin has clinical applications in alcoholic liver diseases, liver cirrhosis, Amanita mushroom poisoning, viral hepatitis, toxic and drug induced liver diseases and in diabetic patients. "

Therapies and Procedures

1.	Liver Transplantation 12/01/2014 - "Improved prediction of the need for liver transplantation in patients with drug-induced liver injury?" 12/01/2012 - "Drug-induced liver injury is a relevant clinical issue, in severe cases ending in liver transplantation. " 07/01/2012 - "Frequency, clinical presentation, and outcomes of drug-induced liver injury after liver transplantation." 01/04/1985 - "Orthotopic liver transplantation in patients with acute toxic hepatitis has not, to our knowledge, been reported. " 09/01/2005 - "The aim of this study was to determine the nature and number of suspected adverse drug-induced liver disease associated with fatalities and/or liver transplantation since reporting of adverse drug reactions (ADRs) started in Sweden. "
2.	Drug Therapy (Chemotherapy) 10/01/1981 - "Five patients (20%) showed drug-induced hepatitis; in these it was necessary to modify to chemotherapy, the survival time in four cases was 2 to 9.6 months (median 4.8 months) and one is still in remission after 36 months of treatment. " 12/01/2013 - "Drug-induced liver injury (DILI) remains a rare but serious complication in drug therapy that is a primary cause of drug failure during clinical trials. " 02/01/2015 - "Drug-induced liver injury (DILI) is a serious problem in pre-clinical stages of drug development and clinical pharmacotherapy, but the pathogenesis of DILI has not been elucidated. " 07/03/2014 - "Drug-induced liver injury (DILI) is a major safety concern in drug development and clinical pharmacotherapy. " 01/13/2014 - "Drug-induced liver injury (DILI) is a growing concern in the fields of drug development and clinical drug therapy because numerous drugs have been linked to hepatotoxicity. "
3.	Transplantation (Transplant Recipients) 07/01/2015 - "Immune-mediated drug-induced liver injury (IMDILI) can be devastating, irreversible, and fatal in the absence of successful transplantation surgery. " 04/01/2014 - "Liver transplant recipients may also be at increased risk of developing drug induced liver injury (DILI). " 06/01/2013 - "Biopsy was performed on the 22nd d of transplantation and histopathological analysis confirmed the diagnosis of toxic hepatitis. " 08/01/2012 - "It was found that transplantation of neonatal liver cell nuclei in acute toxic hepatitis provides better functional and structural state of the target organ." 08/01/2012 - "Protective effect of transplantation of neonatal liver cell nuclei on the model of acute toxic hepatitis."
4.	Chemoprevention 05/01/2010 - "We describe the case of a patient with PA refractory to disease-modifying drugs, who developed drug-induced hepatitis after chemoprophylaxis with isoniazid, administered prior to the treatment with an anti-TNFα agent. " 01/01/2015 - "The initial diagnosis was fulminant toxic hepatitis due to isoniazid chemoprophylaxis, which was treated successfully with living donor transplantation. " 03/01/1978 - "Chemoprophylaxis with isoniazid carries a risk of drug-induced hepatitis, and this risk needs to be weighed against the advantages of preventing tuberculosis morbidity. "
5.	Radiotherapy 09/01/2006 - "He was discharged after receiving subsequent radiotherapy and remained stable for a while; however, he died of possible drug-induced hepatitis. " 01/01/2009 - " and decreased occurrence of toxic hepatitis, haematological complications, and need for blood and platelet transfusions in group I compared to group II. We can conclude that vitamin E and NAC have been shown to be effective as antioxidant adjuvant therapy in children with ALL to reduce chemo-/radiotherapy-related toxicities during the initial period of treatment."