Clinicopathological patterns of drug-induced liver disease

The liver ranks high on the list of targets affected by adverse reactions to therapeutic or environmental agents (1-4). Awareness of drug-induced reactions affecting the liver has become increasingly a matter of concern. The clinical manifestations of drug-induced liver injury cover the full spectrum of liver disorders. It is often difficult and occasionally impossible to separate clinical manifestation caused by a drug from those caused by the underlying illness. Of particular concern are those drug-induced injuries that lead to clinically severe liver disease and acute liver failure (5). Much attention has been focused on drugs that were evaluated and approved, which later were withdrawn because of hepatotoxicity. The challenge is to improve the methods by which potential hepatotoxicity is identified so as to assure that an accurate assessment of risk is made.