Drug induced liver injury screening
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Drug induced liver injury Microchapters |
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Differentiating Drug Induced Liver Injury from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Drug Induced Liver Injury On the Web |
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American Roentgen Ray Society Images of Drug induced liver injury |
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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
General screening guidelines for drug induced liver injury do not exist. However, certain specific guidelines have been established for drugs associated with a high incidence of severe liver injury, e.g. methotrexate.[1] These guidelines remain controversial.
Screening
Periodic screening of serum alanine aminotransferase is sometimes initiated for drugs associated with a high incidence of liver injury, at provider discretion.[2]
However, because frequent laboratory monitoring is often not possible for both patients and providers, compliance with any drug-specific surveillance guidelines is variable and drug-specific guidelines remain controversial. This is largely because the significance of a mildly elevated serum alanine aminotransferase is unclear and may result in inappropriate drug withdrawal in patients who would otherwise adapt to ongoing use of the inciting drug.
References
- ↑ Fries JF, Ramey DR, Singh G (1994). "Suggested guidelines for monitoring liver toxicity in rheumatoid arthritis patients treated with methotrexate: comment on the article by Kremer et al". Arthritis Rheum. 37 (12): 1829–30. PMID 7986233.
- ↑ Davern TJ (2012). "Drug-induced liver disease". Clin Liver Dis. 16 (2): 231–45. doi:10.1016/j.cld.2012.03.002. PMID 22541696.