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This website provides information about the multicenter drug-induced liver

. , injury study sponsored by the NIH. It is a useful resource for references and
medications that have been associated with severe hepatotoxicity.
( >3 mg/dL) Green RM, Flamm S: AGA technical review on the evaluation of liver
. chemistry tests. Gastroenterology. 2002;123:1367-1384.
10% This guideline provides a structured approach for evaluating patients with
( ) elevated liver tests.
. Farrell GC, Larter CZ: Nonalcoholic fatty liver disease: From steatosis
to cirrhosis. Hepatology 43(2 Suppl 1):S99-S112, 2006.
This comprehensive review on the pathogenesis and management of fatty
liver disease provides a perspective on potential therapeutics.
Novak D, Lewis JH: Drug-induced liver disease. Curr Opin Gastro-
enterol 3:203-215, 2003.
This review is a useful clinical resource because it describes the clinical pre-
, , sentation of specific medications associated with drug-induced liver injury. The
. article includes information on herbal hepatotoxicity.
, Sanyal AJ; American Gastrointestinal Association: AGA technical review
on nonalcoholic fatty liver disease. Gastroenterology 123(5):1705-
. 1725, 2002.
This article provides a detailed review on the natural history, pathogenesis,
and management for fatty liver disease.

, 1. Andrade RJ, Jucena ML, Fernandez MC, et al: Drug induced liver
injury: An analysis of 461 incidences submitted to the Spanish
. registry over a 10-year period. Gastroenterology 129:512-521,
AST ALT 2005.
3 The authors describe one of the largest series of patients with drug-
induced liver injury and provide a description of clinical and laboratory
. data as well as a list of drugs that cause DILI.
2. Belfort R, Harrison SA, Brown K, et al: A placebo-controlled trial
of pioglitazone in subjects with nonalcoholic steatohepatitis. N
, Engl J Med 255:2297-2307, 2006.
. This key randomized clinical trial demonstrated biochemical and his-
, tologic improvement in patients with nonalcoholic steatohepatitis (NASH)
treated with pioglitazone compared with placebo.
, 3. Matteoni CA, Younossi ZM, Gramlich T, et al: Nonalcoholic fatty
liver disease: A spectrum of clinical and pathological severity. Gas-
. . , troenterology 116(6):1413-1419, 1999.
. The authors provide a complete series of pathologic findings in patients
with fatty liver disease. The study is particularly useful because the specific
, pathologic findings associated with fibrosis are provided.
, 4. Neuschwander-Tetri BA, Brunt EM, Wehmeier KR, et al:
Improved nonalcoholic steatohepatitis after 48 weeks of treat-
. ment with the PPAR-gamma ligand rosiglitazone. Hepatology
38(4):1008-1017, 2003.
The authors describe one of the first trials demonstrating histologic
improvement on liver biopsy with medication. The data from this study
, supported the development of larger studies of glitazones in patients with
NASH.
5. Sanyal AJ, Mofrad PS, Contos MJ, et al: A pilot study of vitamin E
. versus vitamin E and pioglitazone for the treatment of nonalcoholic
steatohepatitis. Clin Gastroenterol Hepatol 2(12):1107-1115, 2004.
This small randomized trial of 20 patients demonstrated that vitamin
E only resulted in a biochemical response with no benefit seen in liver
. Drug Induced Liver histology. The combination of vitamin E and pioglitazone resulted in a
Injury Network biochemical, histologic, and metabolic response.
. 6. Ueno T, Sugawara H, Sujaku K, et al: Therapeutic effects of
restricted diet and exercise in obese patients with fatty liver.
J Hepatol 27(1):103-107, 1997.
Data from this study demonstrated that patients with fatty liver
disease benefited from weight loss and exercise, supporting the clinicians’
recommendation that changes in lifestyle can lead to improvement in
Drug Induced Liver Injury Network. Available at: http://dilin.dcri.duke. liver disease.
edu/index.html. Accessed August 29, 2006.