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Identifying idiosyncratic drug\u2010induced liver injury (<jats:styled-content style=\"fixed-case\">iDILI<\/jats:styled-content>) may be particularly difficult, but the illness generally follows a subacute course, allowing time to assess outcome and find a liver graft if needed. Not all drugs that cause<jats:styled-content style=\"fixed-case\">iDILI<\/jats:styled-content>lead to<jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content>; the most common are antibiotics including anti\u2010tuberculous medications, non\u2010steroidal anti\u2010inflammatory agents and herbal and dietary supplements (<jats:styled-content style=\"fixed-case\">HDS<\/jats:styled-content>). Determining causality remains challenging particularly if altered mentation is present; identifying the causative agent depends in part on knowing the propensity of the drugs that have been taken in the proper time interval, plus excluding other causes. In general,<jats:styled-content style=\"fixed-case\">iDILI<\/jats:styled-content>that reaches the threshold of<jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content>will more often than not require transplantation, since survival without transplant is around 25%. Treatment consists of withdrawal of the presumed offending medication, consideration of<jats:italic>N<\/jats:italic>\u2010acetylcysteine (<jats:styled-content style=\"fixed-case\">NAC<\/jats:styled-content>), as well as intensive care. Corticosteroids have not proven useful except perhaps in instances of apparent autoimmune hepatitis caused by a limited number of agents. Recently developed prognostic scoring systems may also aid in predicting outcome in this setting.<\/jats:p>","DOI":"10.1111\/liv.13535","type":"journal-article","created":{"date-parts":[[2017,8,3]],"date-time":"2017-08-03T20:28:35Z","timestamp":1501792115000},"page":"6-14","source":"Crossref","is-referenced-by-count":90,"title":["Acute liver failure induced by idiosyncratic reaction to drugs: Challenges in diagnosis and therapy"],"prefix":"10.1111","volume":"38","author":[{"given":"Shannan R.","family":"Tujios","sequence":"first","affiliation":[{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2783-5441","authenticated-orcid":false,"given":"William M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases University of Texas Southwestern Medical Center Dallas TX 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