Drug-Induced Liver Injuries (Clinical Guidelines for Physicians)
Aim. Clinical guidelines for the management of adult patients suffering from drug-induced liver injuries (DILI) are intended for all medical specialists, who treat such patients in their clinical practice.Key findings. The presented recommendations contain information about the epidemiological data,...
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| Format: | Article |
| Language: | Russian |
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Gastro LLC
2019-03-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/332 |
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| author | Vladimir T. Ivashkin Andrey Yu. Baranovsky Karina L. Raikhelson Lyudmila K. Palgova Marina V. Maevskaya Elina A. Kondrashina Natalya V. Marchenko Tatyana P. Nekrasova Igor G. Nikitin |
| author_facet | Vladimir T. Ivashkin Andrey Yu. Baranovsky Karina L. Raikhelson Lyudmila K. Palgova Marina V. Maevskaya Elina A. Kondrashina Natalya V. Marchenko Tatyana P. Nekrasova Igor G. Nikitin |
| author_sort | Vladimir T. Ivashkin |
| collection | DOAJ |
| description | Aim. Clinical guidelines for the management of adult patients suffering from drug-induced liver injuries (DILI) are intended for all medical specialists, who treat such patients in their clinical practice.Key findings. The presented recommendations contain information about the epidemiological data, terminology, diagnostic principles, classification, prognosis and management of patients with DILI. The recommendations list pharmacological agents that most commonly cause DILI, including its fatal cases. Dose-dependent and predictable (hepatotoxic), as well as dose-independent and unpredictable (idiosyncratic) DILI forms are described in detail, which information has a particular practical significance. The criteria and types of DILI are described in detail, with the most reliable diagnostic and prognostic scales and indices being provided. The pathogenesis and risk factors for the development of DILI are considered. The clinical and morphological forms (phenotypes) of DILI are described. The diseases that are included into the differential diagnosis of DILI, as well as the principles of its implementation, are given. The role and significance of various diagnostic methods for examining a patient with suspected DILI is described, with the liver biopsy role being discussed. Clinical situations, in which DILI can acquire a chronic course, are described. A section on the assessment of causal relationships in the diagnosis of DILI is presented; the practical value of using the CIOMS-RUCAM scale is shown. All possible therapeutic measures and pharmacological approaches to the treatment of patients with various DILI phenotypes are investigated in detail. A particular attention is paid to the use of glucocorticosteroids in the treatment of DILI.Conclusion. The presented clinical recommendations are important for improving the quality of medical care in the field of hepatology. |
| format | Article |
| id | doaj-art-48f0d3360b1949fcbcfeb449bf7ccf68 |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2019-03-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-48f0d3360b1949fcbcfeb449bf7ccf682025-02-10T16:14:35ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732019-03-012918511510.22416/1382-4376-2019-29-1-101-131290Drug-Induced Liver Injuries (Clinical Guidelines for Physicians)Vladimir T. Ivashkin0Andrey Yu. Baranovsky1Karina L. Raikhelson2Lyudmila K. Palgova3Marina V. Maevskaya4Elina A. Kondrashina5Natalya V. Marchenko6Tatyana P. Nekrasova7Igor G. Nikitin8I.M. Sechenov First Moscow State Medical University (Sechenov University)Institute of High Technologies, Saint Petersburg State UniversityInstitute of High Technologies, Saint Petersburg State UniversityInstitute of High Technologies, Saint Petersburg State UniversityI.M. Sechenov First Moscow State Medical University (Sechenov University)Institute of High Technologies, Saint Petersburg State UniversityInstitute of High Technologies, Saint Petersburg State UniversityI.M. Sechenov First Moscow State Medical University (Sechenov University)Pirogov Russian National Research Medical UniversityAim. Clinical guidelines for the management of adult patients suffering from drug-induced liver injuries (DILI) are intended for all medical specialists, who treat such patients in their clinical practice.Key findings. The presented recommendations contain information about the epidemiological data, terminology, diagnostic principles, classification, prognosis and management of patients with DILI. The recommendations list pharmacological agents that most commonly cause DILI, including its fatal cases. Dose-dependent and predictable (hepatotoxic), as well as dose-independent and unpredictable (idiosyncratic) DILI forms are described in detail, which information has a particular practical significance. The criteria and types of DILI are described in detail, with the most reliable diagnostic and prognostic scales and indices being provided. The pathogenesis and risk factors for the development of DILI are considered. The clinical and morphological forms (phenotypes) of DILI are described. The diseases that are included into the differential diagnosis of DILI, as well as the principles of its implementation, are given. The role and significance of various diagnostic methods for examining a patient with suspected DILI is described, with the liver biopsy role being discussed. Clinical situations, in which DILI can acquire a chronic course, are described. A section on the assessment of causal relationships in the diagnosis of DILI is presented; the practical value of using the CIOMS-RUCAM scale is shown. All possible therapeutic measures and pharmacological approaches to the treatment of patients with various DILI phenotypes are investigated in detail. A particular attention is paid to the use of glucocorticosteroids in the treatment of DILI.Conclusion. The presented clinical recommendations are important for improving the quality of medical care in the field of hepatology.https://www.gastro-j.ru/jour/article/view/332drug-induced liver injuriesdrug-induced liver injury diagnosisdrug-induced liver injury phenotypesdrug-induced liver injury classificationdrug-induced liver injury prognosisdrug-induced liver injury patient managementpharmacotherapyglucocorticosteroids |
| spellingShingle | Vladimir T. Ivashkin Andrey Yu. Baranovsky Karina L. Raikhelson Lyudmila K. Palgova Marina V. Maevskaya Elina A. Kondrashina Natalya V. Marchenko Tatyana P. Nekrasova Igor G. Nikitin Drug-Induced Liver Injuries (Clinical Guidelines for Physicians) Российский журнал гастроэнтерологии, гепатологии, колопроктологии drug-induced liver injuries drug-induced liver injury diagnosis drug-induced liver injury phenotypes drug-induced liver injury classification drug-induced liver injury prognosis drug-induced liver injury patient management pharmacotherapy glucocorticosteroids |
| title | Drug-Induced Liver Injuries (Clinical Guidelines for Physicians) |
| title_full | Drug-Induced Liver Injuries (Clinical Guidelines for Physicians) |
| title_fullStr | Drug-Induced Liver Injuries (Clinical Guidelines for Physicians) |
| title_full_unstemmed | Drug-Induced Liver Injuries (Clinical Guidelines for Physicians) |
| title_short | Drug-Induced Liver Injuries (Clinical Guidelines for Physicians) |
| title_sort | drug induced liver injuries clinical guidelines for physicians |
| topic | drug-induced liver injuries drug-induced liver injury diagnosis drug-induced liver injury phenotypes drug-induced liver injury classification drug-induced liver injury prognosis drug-induced liver injury patient management pharmacotherapy glucocorticosteroids |
| url | https://www.gastro-j.ru/jour/article/view/332 |
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