Drug-induced liver injury in inflammatory bowel disease: Challenges in diagnosis and monitoring

Figure 1 Challenges in the diagnosis of drug induced liver injury in patients with inflammatory bowel disease. AIH: Autoimmune hepatitis; LFT: Liver function test; MASLD: Metabolic dysfunction associated steatotic liver disease; PSC: Primary sclerosing cholangitis; RUCAM: Roussel Uclaf Causality Assessment Method; DILI: Drug induced liver injury; IBD: Inflammatory bowel disease.

Figure 2 Approach to drug induced liver injury in a patient with inflammatory bowel disease. ¹Patients with symptomatic disease have poor outcomes. AST: Aspartate transaminase; ALT: Alanine transaminase; ALP: Alkaline phosphatase; ANA: Antinuclear antibody; ASMA: Anti-smooth muscle antibody; AMA: Anti-mitochondrial antibody; IgG: Immunoglobulin G; HBsAg: Hepatitis B surface antigen; Anti HBs: Antibody to hepatitis B surface antigen; HAV: Hepatitis A virus; HCV: Hepatitis C virus; HEV: Hepatitis E virus; LKM-1: Liver kidney microsome antibody; ULN: Upper limited normal; SOS: Sinusoidal obstruction syndrome; NRH: Nodular regenerative hyperplasia; DILI: Drug induced liver injury; IBD: Inflammatory bowel disease.