Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China.
Department of Infectious Diseases, The 920th Hospital of Chinese PLA Joint Logistics Support Force, Kunming, 650032, Yunnan, China.
Hepatol Int. 2024 Apr;18(2):384-419. doi: 10.1007/s12072-023-10633-7. Epub 2024 Feb 24.
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.
药物性肝损伤（DILI）是一种重要的药物不良反应，在严重情况下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，详细的病史采集和彻底、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证据制定，旨在为临床医生提供如何及时识别疑似 DILI 以及规范临床实践中的诊断和管理的专业指导。根据中国的临床情况，本指南还特别关注慢性肝病中的 DILI、药物性肝炎病毒再激活、DILI 的常见致病药物（草药和膳食补充剂、抗结核药物和抗肿瘤药物）以及临床试验中的 DILI 信号及其评估。
