The DOI matches its Crossref record; 366 of the 371 references it cites were found in a registry or an index.
EASL Clinical Practice Guidelines: Drug-induced liver injury
Abstract
Idiosyncratic (unpredictable) drug-induced liver injury is one of the most challenging liver disorders faced by hepatologists, because of the myriad of drugs used in clinical practice, available herbs and dietary supplements with hepatotoxic potential, the ability of the condition to present with a variety of clinical and pathological phenotypes and the current absence of specific biomarkers. This makes the diagnosis of drug-induced liver injury an uncertain process, requiring a high degree of awareness of the condition and the careful exclusion of alternative aetiologies of liver disease. Idiosyncratic hepatotoxicity can be severe, leading to a particularly serious variety of acute liver failure for which no effective therapy has yet been developed. These Clinical Practice Guidelines summarize the available evidence on risk factors, diagnosis, management and risk minimization strategies for drug-induced liver jury.
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In the citing paper
“Drug-induced liver injury (DILI) is an uncommon adverse reaction to drugs, and other chemicals, including herbal and dietary supplements (HDS).”
From DILI Differences and Similarities between the US and Europe (2026) · cites this paper as [2]
In the citing paper
“The vast majority of cases of DILI occur at therapeutic doses in a small proportion of individuals exposed to the drug, representing an idiosyncratic reaction, and therefore unpredictable based on the drug's mechanism of action and related to the uniqueness of the individual [1,2].”
From DILI Differences and Similarities between the US and Europe (2026) · cites this paper as [2]
In the citing paper
“In pediatric medicine, DILI is a rare clinical situation. However, it has high morbidity and mortality, and it is one of the most common causes of acute liver failure. Furthermore, its diagnosis is clinically challenging due to its low incidence and phenotypic variability [6,7,8].”
From Metabolomic Analysis of Pediatric Patients with Idiosyncratic Drug-Induced Liver Injury According to the Updated RUCAM (2023) · cites this paper as [7]
In the citing paper
“The lack of a reliable diagnostic biomarker and evidence-based treatment paradigm has resulted in limited guidance on how to manage this aspect of DILI.”
From Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report (2023) · cites this paper as [2]
In the citing paper
“The lack of reliable diagnostic biomarkers and an evidence-based treatment paradigm has resulted in limited guidance on how to manage this aspect of DILI.2,25–27”
From Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report (2023) · cites this paper as [2]
In the citing paper
“However, drug rechallenge in DILI cases is potentially dangerous2,75 and is associated with risk of death or requirement for liver transplant.”
From Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report (2023) · cites this paper as [2]
In the citing paper
“Although there are some ambiguities regarding how to score certain sections as well as suboptimal reliability, RUCAM can provide systematic and framed guidance for the assessment of patients with suspected DILI and is the most widely used tool [26,27,51,59].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [26]
In the citing paper
“High TBil and ALP levels in the second month after an acute DILI episode and the biochemical nonresolution-6 model may help predict the risk of chronic injury and delayed recovery [26,72].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [26]
In the citing paper
“Although there are some ambiguities regarding how to score certain sections as well as suboptimal reliability, RUCAM can provide systematic and framed guidance for the assessment of patients with suspected DILI and is the most widely used tool [26,27,51,59].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [26]
In the citing paper
“Its potential value in confirming or excluding hepatocellular injury in cases of elevated ALT levels from a suspected extrahepatic origin (e.g., muscle) has been evaluated [26,175].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [26]
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5 of the 371 references couldn’t be matched to a known paper.
Research works printed but not linked: 5
- Nicoletti, 2017, Genome-wide association study (GWAS) to identify genetic risk factors that increase susceptibility to antituberculosis drug-induced liver injury (ATDILI) [Abstract], Hepatology, 66, A-25
- Lim, 2008, Association of HLA-B*1502 allele and carbamazepine-induced severe adverse cutaneous drug reaction among Asians, a review, Neurol Asia, 13, 15
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Metadata
- Authors
- Andrade, R. J., Aithal, G. P., Björnsson, E. S., Kaplowitz, N., Kullak-Ublick, G. A., Larrey, D., & Karlsen, T. H.
- ORCID
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2019-06
- Volume
- 70
- Issue
- 6
- Pages
- 1222-1261
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2924328881
- Semantic Scholar
- 6d774d1c570eef200451a1e8a8f5655c367a4eaf
- Cited by
- 1,276
- References
- 371
- Citations by year
- 2026: 243 · 2025: 211 · 2024: 175 · 2023: 159 · 2022: 158 · 2021: 184 · 2020: 117 · 2019: 27
- FWCI
- 78.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Cooperation in Science & Technology
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- drug-induced liver injury, idiosyncratic drug-induced liver injury, hepatotoxicity, acute liver failure, risk factors, diagnosis, risk minimization
- MeSH terms
- Adult, Aged, Fatty Liver, Female, Histocompatibility Testing, Humans, Liver Neoplasms, Male, Middle Aged, Mitochondria, Risk Factors, Chemical and Drug Induced Liver Injury
About these checks
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