Zhonghua Gan Zang Bing Za Zhi. 2023 Apr 20;31(4):355-384. doi: 10.3760/cma.j.cn501113-20230419-00176-1.
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, anti-neoplastic drugs), and signal and assessment of DILI in clinical trials.
药物性肝损伤（DILI）是一种重要的药物不良反应，严重时可导致急性肝衰竭甚至死亡。目前，DILI的诊断仍遵循排除策略。因此，详细询问病史并全面、仔细地排除其他潜在的肝损伤原因是正确诊断的关键。本指南基于最新研究进展提供的循证医学制定，旨在为临床医生提供专业指导，以帮助他们及时识别疑似DILI，并在临床实践中规范诊断和管理。基于中国的临床实际情况，本指南还特别关注了慢性肝病中的DILI、药物性病毒性肝炎再激活、DILI的常见致病药物（草药和膳食补充剂、抗结核药物、抗肿瘤药物）以及临床试验中DILI的信号和评估。
