DISI is more common than DILI
, and may or may not be caused by an immune response.
According to the reports, an accused namely, Hadi Bux axed his elder brother identified as Mor Shar over petty matter and as a result, he was killed on the spot in the village, Dili
has a complex pathogenesis that can be summarized into direct hepatotoxicity and idiosyncratic hepatotoxicity reactions to drugs.
To our knowledge, this is the first report of everolimus associated DILI
. A DILI
score model was created to better predict the potential of a drug to cause liver injury and the severity of the injury based on the lipophilicity of the drug (logP [greater than or equal to] 3), covalent binding of reactive metabolites, and the daily dose of the oral medication ([greater than or equal to] 100 mg) .
The Roussel Uclaf Causality Assessment Method score was 9, which was consistent with highly probable DILI
A liver biopsy showed mixed inflammatory infiltrate of lymphocytes, neutrophils, and eosinophils with rare necrotic hepatocytes and canalicular and intrahepatocellular cholestasis, all of which are consistent with DILI
(Figures 1 and 2).
With a suspected DILI
, withdraw of the antituberculosis drugs was determined and other causes of liver injury were excluded, such as viral hepatitis, concomitant HIV infection, alcohol consumption, and the use of other hepatotoxic offenders.
Risk factors for DILI
can be classified as drug-related (eg, dose, concomitant medications, polypharmacy) or host-related (eg, age, gender, alcohol intake, concomitant infections).
While incidents of DILI
and, more important, severe DILI
, continue to be low in the United States, DILI
is the leading cause of acute liver failure in Americans, and a major cause of emergency liver transplant.
Drugs may cause liver injury in a predictable dose-dependent manner in most human and animal settings (intrinsic DILI
) or in an unpredictable, non-dose-dependent manner (idiosyncratic DILI
The effect of antiretroviral therapy (ART) on TB DILI
is not clear.