TY - JOUR AU - Bessone, Fernando; Robles-Diaz, Mercedes; Hernandez, Nelia; Medina-Caliz, Inmaculada; Lucena, M. Isabel; Andrade, Raul J. TI - Assessment of Serious Acute and Chronic Idiosyncratic Drug-Induced Liver Injury in Clinical Practice SN - 0272-8087 SN - 1098-8971 PY - 2019 JO - Semin Liver Dis JF - Seminars in Liver Disease LA - EN VL - 39 IS - 03 SP - 381 EP - 394 ET - 2019/05/02 DA - 2019/08/02 KW - hepatotoxicity KW - acute liver failure KW - chronic DILI KW - risk factors KW - histopathology AB - 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. PB - Thieme Medical Publishers DO - 10.1055/s-0039-1685519 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0039-1685519 ER -