Hospital Provincial del Centenario, University of Rosario School of Medicine, Rosario, Argentina.
Unidad de Gestión Clínica de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Semin Liver Dis. 2019 Jul;39(3):381-394. doi: 10.1055/s-0039-1685519. Epub 2019 May 2.
Drug-induced liver injury (DILI) is the leading cause of acute liver failure (ALF) in developed countries. The extremely variable phenotype of DILI, both in presentation and in severity, is one of the distinctive characteristics of the disease and one of the major challenges that hepatologists face when assessing hepatotoxicity cases. A new Hy's law that more accurately predicts the risk of ALF related to DILI has been proposed and validated. Other prognostic scoring algorithms for the early identification of DILI patients who may go on to develop ALF have been developed as it is of most clinical relevance to stratify patients for closer monitoring. Recent data indicate that acute DILI often presents a more prolonged resolution or evolves into chronicity at a higher frequency than other forms of acute liver injury. Risk factors for chronicity, specific phenotypes, and histological features are discussed in this study. Biomarkers to predict DILI outcome are in need.
药物性肝损伤（DILI）是发达国家急性肝衰竭（ALF）的主要原因。DILI 在表现和严重程度上具有极其多变的表型，这是该疾病的显著特征之一，也是肝病学家在评估肝毒性病例时面临的主要挑战之一。已经提出并验证了一种新的更准确预测与 DILI 相关的 ALF 风险的 Hy's 法则。还开发了其他预测评分算法，以早期识别可能发展为 ALF 的 DILI 患者，因为对患者进行分层以进行更密切监测在临床上最为相关。最近的数据表明，急性 DILI 通常比其他形式的急性肝损伤表现出更长时间的缓解或更频繁地发展为慢性。本研究讨论了慢性的危险因素、特定表型和组织学特征。需要预测 DILI 结局的生物标志物。
