Drug induced liver injury classification

	Drug induced liver injury Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Drug Induced Liver Injury from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Biopsy
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Drug Induced Liver Injury On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Drug induced liver injury All Images induced liver injury X-ray X-rays induced liver injury Ultrasound Echo & Ultrasound induced liver injury CT CT Images induced liver injury MRI MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Drug induced liver injury
CDC on Drug induced liver injury
Drug induced liver injury in the news
Blogs on Drug induced liver injury
Directions to Hospitals Treating Drug induced liver injury
Risk calculators and risk factors for Drug induced liver injury

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rachita Navara, M.D. [2]

Overview

Drug induced liver injury may be classified into multiple subtypes based on clinical presentation, mechanism, or histologic findings.^[1]

Drug induced liver injury may be classified into multiple subtypes based on clinical presentation, mechanism, or histologic findings.

Elevation of serum transaminases ≥ 2-5 times the upper limit of normal
May have hyperbilirubinemia
May have abnormal synthetic function tests (e.g. International Normalized Ratio, albumin)

Elevation of alkaline phosphatase ≥ 3 times the upper limit of normal
May have hyperbilirubinemia
May have abnormal synthetic function tests (e.g. International Normalized Ratio, albumin)

Both alkaline phosphatase and transaminases are elevated in roughly equal proportion, and/or an alanine aminotransferase to alkaline phosphatase ratio between 2-5

e.g. Stimulation of immune reponse by biologic agents, independent of dose, akin to drug hypersensitivity
e.g. Altered host genes involved in drug metabolism

Histologic findings may be further subclassified into:

↑ Fisher K, Vuppalanchi R, Saxena R (2015). "Drug-Induced Liver Injury". Arch Pathol Lab Med. 139 (7): 876–87. doi:10.5858/arpa.2014-0214-RA. PMID 26125428.