Drug-induced liver injury is a potential complication of nearly every medication that is prescribed, because the liver is central to the metabolic disposition of virtually all drugs and foreign substances.1–3 Although drugs are usually metabolized without injury to the liver, many fatal and near-fatal drug reactions occur each year. A few compounds produce metabolites that cause liver injury in a uniform, dose-dependent fashion.4–6 Most agents form a toxic byproduct only in rare persons. Injury to hepatocytes results either directly from the disruption of intracellular function or membrane integrity or indirectly from immune-mediated membrane damage. Factors promoting the accumulation.
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