Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review
Drug-induced liver injury (DILI) poses a complex and heterogeneous clinical challenge, which often resembles non-drug related acute or chronic liver diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). Furthermore, certain drugs can induce hepatic steatosis, which is c...
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| Format: | Article |
| Language: | English |
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Open Exploration Publishing Inc.
2023-12-01
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| Series: | Exploration of Digestive Diseases |
| Subjects: | |
| Online Access: | https://www.explorationpub.com/Journals/edd/Article/100534 |
| _version_ | 1797367891333480448 |
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| author | Miren García-Cortés Juan Pedro Toro-Ortiz Alberto García-García |
| author_facet | Miren García-Cortés Juan Pedro Toro-Ortiz Alberto García-García |
| author_sort | Miren García-Cortés |
| collection | DOAJ |
| description | Drug-induced liver injury (DILI) poses a complex and heterogeneous clinical challenge, which often resembles non-drug related acute or chronic liver diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). Furthermore, certain drugs can induce hepatic steatosis, which is considered a rare variant of hepatotoxicity. Additionally, the detection and diagnosis of DILI in patients with non-alcoholic liver disease present additional challenges that require attention. The importance of achieving an accurate diagnosis is highlighted by the different therapeutic approaches needed for each of these diseases. Nonetheless, as definitive diagnostic tests and distinct biomarkers often remain elusive, the differential diagnosis must rely on a combination of clinical, biochemical, histological, and immunophenotypic profiling. The diagnosis of hepatotoxicity is predicated upon the temporal nexus between the administration of a potentially hepatotoxic drug and the onset of hepatic injury, concomitantly excluding alternative hepatic pathologies. More frequently, this condition presents an acute course, with a more pronounced elevation of cytolytic and cholestatic parameters as compared to fatty liver disease. Advances in elucidating the underlying mechanisms hold promise for bolstering the diagnosis and management of these conditions. This article aims to thoroughly examine and emphasize the currently available scientific evidence to provide valuable insights into the diagnostic strategies for DILI, metabolic-associated liver disease, and drug-induced steatosis (DIS). |
| first_indexed | 2024-03-08T17:23:42Z |
| format | Article |
| id | doaj.art-5d274a4166164b0f8f9d6cc14d262e2d |
| institution | Directory Open Access Journal |
| issn | 2833-6321 |
| language | English |
| last_indexed | 2024-03-08T17:23:42Z |
| publishDate | 2023-12-01 |
| publisher | Open Exploration Publishing Inc. |
| record_format | Article |
| series | Exploration of Digestive Diseases |
| spelling | doaj.art-5d274a4166164b0f8f9d6cc14d262e2d2024-01-03T01:36:06ZengOpen Exploration Publishing Inc.Exploration of Digestive Diseases2833-63212023-12-012631833610.37349/edd.2023.00034Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative reviewMiren García-Cortés0https://orcid.org/0000-0003-0410-8273Juan Pedro Toro-Ortiz1https://orcid.org/0000-0002-1384-7193Alberto García-García2https://orcid.org/0000-0003-0851-6442Service of Gastroenterology and Hepatology, University Virgen de la Victoria Hospital, 29010 Málaga, Spain; Instituto de investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, University of Málaga, 29010 Málaga, Spain; Centro de Investigación Biomédico en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, SpainService of Gastroenterology and Hepatology, University Virgen de la Victoria Hospital, 29010 Málaga, SpainService of Gastroenterology and Hepatology, University Virgen de la Victoria Hospital, 29010 Málaga, SpainDrug-induced liver injury (DILI) poses a complex and heterogeneous clinical challenge, which often resembles non-drug related acute or chronic liver diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). Furthermore, certain drugs can induce hepatic steatosis, which is considered a rare variant of hepatotoxicity. Additionally, the detection and diagnosis of DILI in patients with non-alcoholic liver disease present additional challenges that require attention. The importance of achieving an accurate diagnosis is highlighted by the different therapeutic approaches needed for each of these diseases. Nonetheless, as definitive diagnostic tests and distinct biomarkers often remain elusive, the differential diagnosis must rely on a combination of clinical, biochemical, histological, and immunophenotypic profiling. The diagnosis of hepatotoxicity is predicated upon the temporal nexus between the administration of a potentially hepatotoxic drug and the onset of hepatic injury, concomitantly excluding alternative hepatic pathologies. More frequently, this condition presents an acute course, with a more pronounced elevation of cytolytic and cholestatic parameters as compared to fatty liver disease. Advances in elucidating the underlying mechanisms hold promise for bolstering the diagnosis and management of these conditions. This article aims to thoroughly examine and emphasize the currently available scientific evidence to provide valuable insights into the diagnostic strategies for DILI, metabolic-associated liver disease, and drug-induced steatosis (DIS).https://www.explorationpub.com/Journals/edd/Article/100534drug-induced liver injurymetabolic dysfunction-associated steatotic liver diseasenon-alcoholic fatty liver diseasedrug-induced steatosis |
| spellingShingle | Miren García-Cortés Juan Pedro Toro-Ortiz Alberto García-García Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review Exploration of Digestive Diseases drug-induced liver injury metabolic dysfunction-associated steatotic liver disease non-alcoholic fatty liver disease drug-induced steatosis |
| title | Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review |
| title_full | Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review |
| title_fullStr | Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review |
| title_full_unstemmed | Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review |
| title_short | Deciphering the liver enigma: distinguishing drug-induced liver injury and metabolic dysfunction-associated steatotic liver disease—a comprehensive narrative review |
| title_sort | deciphering the liver enigma distinguishing drug induced liver injury and metabolic dysfunction associated steatotic liver disease a comprehensive narrative review |
| topic | drug-induced liver injury metabolic dysfunction-associated steatotic liver disease non-alcoholic fatty liver disease drug-induced steatosis |
| url | https://www.explorationpub.com/Journals/edd/Article/100534 |
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