Drug-induced liver injury: Hy's rule revisited.

摘要

Drag-induced liver injury is a potential complication of many drags. This is to be expected because the liver plays a central role in drag metabolism. Only a very few drags causing drag-induced liver injury have a predictable, dose-dependent toxic mechanism of action, the most widely recognized being acetaminophen (INN, paracetamol) and, to some extent, methotrexate. When acetaminophen overdose is excluded, in most cases drag-induced liver injuries are due to rare, unpredictable reactions of commonly used drags. These unpredictable reactions are mostly either idiosyncratic or immune-mediated, or both, but may also, in some cases, have a dose-related component. Current definition of drag-induced liver injury is dependent on nonspecific elevations in liver test results, in particular, increases in aminotransferase levels.