{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:04:44Z","timestamp":1784307884420,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Drug\u2010induced liver injury (DILI) remains a diagnosis of exclusion and requires systematic causality assessment. Meropenem is generally considered hepatically safe; however, rare cases of idiosyncratic DILI have been reported. We describe a 33\u2010year\u2010old female who developed progressive elevation of liver tests following exposure to meropenem. Based on\n                    <jats:italic>R<\/jats:italic>\n                    \u2010value calculation, the liver injury pattern was mixed at presentation and peak, with transient hepatocellular features followed by evolution toward a cholestatic pattern during recovery. Extensive imaging, endoscopic evaluation, and serologic testing excluded biliary obstruction, viral hepatitis, and autoimmune disease. Causality assessment using the updated Roussel Uclaf Causality Assessment Method (RUCAM, 2016) yielded a score of 4, indicating possible DILI. This case expands the demographic spectrum of reported meropenem\u2010associated DILI and underscores the importance of early\n                    <jats:italic>R<\/jats:italic>\n                    \u2010value calculation, formal RUCAM\u2010based causality assessment, and prompt withdrawal of the suspected agent.\n                  <\/jats:p>","DOI":"10.1002\/ccr3.72792","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T05:23:42Z","timestamp":1779513822000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Meropenem\u2010Induced Possible Mixed Drug\u2010Induced Liver Injury With Cholestatic Evolution: A Case Report Evaluated Using the Updated\n                    <scp>RUCAM<\/scp>\n                    (2016)"],"prefix":"10.1002","volume":"14","author":[{"given":"Nidal","family":"Mutawodeh","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences An\u2010Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1323-2682","authenticated-orcid":false,"given":"Sarah","family":"Saife","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences An\u2010Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram","family":"Shalaby","sequence":"additional","affiliation":[{"name":"University Hospitals  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamaleldein","family":"Einar","sequence":"additional","affiliation":[{"name":"Department of Lymphoma\/Myeloma Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motasem","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences An\u2010Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malik","family":"Hijaz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences An\u2010Najah National University  Nablus Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Hamadneh","sequence":"additional","affiliation":[{"name":"Grand Strand Medical Center  Myrtle Beach South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562848231163410"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001462"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2013.09.016"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17010014"},{"key":"e_1_2_13_6_1","doi-asserted-by":"crossref","unstructured":"Drug\u2010Induced Liver Injury | Clinical Infectious Diseases | Oxford Academic https:\/\/academic.oup.com\/cid\/article\u2010abstract\/38\/Supplement_2\/S44\/330611?redirectedFrom=fulltext.","DOI":"10.1086\/381446"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00853"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.9.953"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/20009666.2020.1845929"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.5799\/jmid.328938"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr\u20102018\u2010227124"},{"key":"e_1_2_13_12_1","volume-title":"Meropenem Induced Mixed Hepatocellular and Cholestatic Hepatitis: A Report of Two Cases","author":"Ba\u015fg\u00f6z B. 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