| [ Summary ] |
The relationship between drug administration and liver injury and exclusion diagnosis of other causes of liver injury are important for the diagnosis of drug-induced liver injury (DILI). We have modified the diagnostic scale of Roussel-Uclaf causality assessment method (RUCAM). We also presented diagnostic criteria at a workshop during the "Digestive Disease Week of Japan 2004"(DDW-J 2004). After classification of the type of liver injury by ALT and ALP levels at diagnosis, scoring is performed in relation to the following factors：1) time to onset, 2) course, 3) risk factors, 4) search for non-drug causes, 5) previous information on hepatotoxicity, 6) eosinophilia, 7) results of drug-lymphocyte stimulation tests (DLST) and 8) response to unplanned readministraion. Score evaluations are made as follows: 2≤: low possibility, 3 and 4：possible; ≥5: high possibility. This diagnostic criteria is now widely used in Japan. However, further modification will be needed after collecting and analyzing more DILI cases. |