Drug-induced liver injury. Need of a new approach to an old problem

Abstract

Introduction: Drug-Induced Liver Injury (DILI) is a broad term that applies to any liver injury from a prescription or over-the-counter drug, herb, or dietary supplement that manifests as a spectrum clinically diverse, from elevations in asymptomatic liver tests to liver failure. Case presentation: We present a case documented in our hospital in the first quarter of 2019, of a 53-year-old male patient with a 2-week history of fever with a history of multiple drug use one month prior to admission. The viral screening, bacterial fungal and immunological tests were negative, as well as the imaging studies carried out. Improvement was evident after withdrawal of all the drugs used, and evidence of injury associated with drug toxicity was confirmed by liver biopsy. Discussion: This pathology is an adverse pharmacological reaction, and can lead to liver failure and even death, if a timely diagnosis is not made. There is need for a simple objective diagnostic test, but there is the lack of consensus on which lab abnormalities are specific; despite being an old problem, there is lack of systematic report of cases that help establish causality. Conclusion: Clinicians and researchers should continue reporting these cases, even the apparent low incidence of these events in our region.