{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:33:04Z","timestamp":1780511584788,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>It can be difficult to distinguish between drug\u2010induced liver injury (DILI) and liver injury associated with sepsis (sepsis induced liver injury, SILI). The aims of the study were to compare clinical and biochemical features between DILI and SILI and identify distinguishing characteristics that might assist in diagnosing these conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohorts of all DILI cases diagnosed in Iceland 2009\u20132024 and SILI 2006\u20132024 were divided into hepatocellular and cholestatic (CS\/mixed) patterns. Patients had: &gt;\u20095\u00d7 upper limit of normal (ULN) of ALT and\/or &gt;\u20092\u00d7 ULN in ALP. RUCAM and expert opinion were used in the causality assessment of DILI, and SILI patients had to fulfil international consensus criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall 275 DILI patients (median age 59\u2009years, 63% females), 153 with SILI (67\u2009years, 49% females) were included. Among patients with HC type, 57% with SILI and only one (0.9%) with DILI had normal liver tests 2\u2009weeks after the event. The peak value of AST was 1794 (IQR 931\u20133526) IU\/L in HC type of SILI but 584 (315\u20131013) IU\/L in DILI, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001. CS\/mixed type of SILI resolved also significantly faster while CS\/mixed pattern of DILI had significantly higher ALP at onset and peak ALT than SILI. SILI had 30% mortality compared to DILI (2%) <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Marked elevation of AST and rapid resolution with a HC pattern of liver injury favours the diagnosis of SILI. Cholestatic\/mixed SILI also resolves rapidly in contrast to CS\/mixed DILI that is associated with markers of more pronounced liver injury.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.70090","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T10:23:01Z","timestamp":1745230981000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Identification of Distinguishing Features of Drug\u2010Induced Liver Injury and Liver Injury Associated With Sepsis"],"prefix":"10.1111","volume":"45","author":[{"given":"Egill","family":"Logason","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigurdur S\u00f6lvi","family":"Sigurdarson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Bj\u00f6rnsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edda","family":"Vesteinsdottir","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Landspitali University Hospital  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigurbergur","family":"Karason","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Iceland  Reykjavik Iceland"},{"name":"Department of Anesthesia and Intensive Care Landspitali University Hospital  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3924-4830","authenticated-orcid":false,"given":"Guruprasad 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