Drug induced liver injury ( DILI )
CC: high LFT
Diagnosis:
Drug induced liver injury ( DILI )
Examples:
Herbal
Over-the-counter
anti-TB
Acetaminophen
Augmentin
anti epileptics like phenytoin & valproate
Statins
Diagnosis ?
At least one of following:
• Serum AST or ALT > 5 times upper limit of normal or ALK PHOSPH > 2 times upper limit of
normal ( or the baseline value if baseline is elevated ) on two separate occasions
• Total bilirubin > 42.7 umol/L with elevated AST, ALT or ALP
• INR > 1.5 with elevated AST,ALT or ALP
What will you do ?
Discontinue offending drug if fulfill above criteria otherwise close observation
+/- hepatology consult, neurology consult ( anti epileptic drugs )
Approach to anti - TB liver injury
