Abstract Idiosyncratic drug‐induced liver injury (DILI) is a challenging liver disorder because it can present with a range of phenotypes, mimicking almost every other hepatic disease, and lacks specific biomarkers for its diagnosis. Hence, a confident DILI diagnosis is seldom possible as it relies on the precise establishment of a temporal sequence between the exposure to a given prescription drug or sometimes hidden herbal product/over the counter medication as well as the exclusion of other aetiologies of liver disease. However, an accurate diagnosis is of most importance, as prompt withdrawal of the causative agent is essential in DILI management. Indeed, DILI can be severe and even fatal or in a fraction of cases evolve to chronic damage, but specific biomarkers for predicting mortality/liver transplantation or a chronic outcome in the very early phases of DILI are not yet available. In this article, we discuss the best diagnostic and prognostic approach of a DILI suspicion by judiciously choosing and interpreting the standard tests currently used in clinical practice.
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机译：摘要 特异质药物性肝损伤（Idiosynceric drug‐induced liver injury，DILI）是一种具有挑战性的肝脏疾病，因为它可以表现为一系列表型，几乎与所有其他肝脏疾病相似，并且缺乏特异性的生物标志物来诊断。因此，确定的DILI诊断几乎是不可能的，因为它依赖于在暴露于给定处方药或有时隐藏的草药产品/非处方药以及排除肝病的其他病因之间的时间序列的精确建立。然而，准确的诊断是最重要的，因为及时停用病原体在DILI管理中至关重要。事实上，DILI可能是严重的，甚至是致命的，或者在一小部分病例中发展为慢性损伤，但目前还没有用于预测死亡率/肝移植或DILI早期阶段慢性结局的特定生物标志物。在本文中，我们通过明智地选择和解释目前临床实践中使用的标准测试，讨论了 DILI 怀疑的最佳诊断和预后方法。
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