Chinese Guideline for the Diagnosis and Management of Drug-Induced Liver Injury in Primary Care (2024)

J Dig Dis. 2025 Jan-Feb;26(1-2):2-21. doi: 10.1111/1751-2980.13337. Epub 2025 Apr 8.

Abstract

Drug-induced liver injury (DILI) is a drug-induced disease that not only complicates the treatment of the primary disease but may also lead to acute liver failure or even death in severe cases. Drugs commonly used in primary care, such as anti-infective agents and nonsteroidal anti-inflammatory drugs, are major causes of DILI. In addition, a large elderly population, comorbidities, and combination therapy with multiple drugs increase the risk of DILI in primary care. Therefore, primary care providers should proactively screen and monitor high-risk patients to identify potential DILI timely. Currently, diagnosis of DILI relies on the exclusion of liver diseases of other etiologies. Collection of detailed medical history of the patients and careful exclusion of other potential liver injury of other etiologies are crucial for accurate diagnosis. This guideline, developed based on evidence-based medicine from the latest research, aimed to provide primary care providers with professional guidance on the timely identification of suspected DILI cases and standardized diagnosis and management in clinical practice.

Keywords: diagnosis; drug‐induced liver injury; guidelines; primary care; treatment.

Publication types

  • Practice Guideline

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Chemical and Drug Induced Liver Injury* / diagnosis
  • Chemical and Drug Induced Liver Injury* / etiology
  • Chemical and Drug Induced Liver Injury* / therapy
  • China
  • Humans
  • Primary Health Care* / standards

Substances

  • Anti-Inflammatory Agents, Non-Steroidal