Abstract
Drug-induced liver injury (DILI) is a frequent adverse event of drugs or medication. From a clinical point of view, this situation can mimic any type of liver disease and there is no specific test (incl. histological examination of liver tissue) enabling precise diagnose.
Therefore, in an era when many different drugs are used, diagnosis of DILI is very difficult. Because of high drug use in medicine and the increasing amount of potentially hepatotoxic drugs, a high proportion of cases of liver injury are being ascribed to drug liver toxicity.
However, this potential simplification of diagnostics can harm the patient by overlooking other (hidden or less frequent at the time of hospitalization) causes of liver disease and by selecting as the causal agent the wrong drug, which is then no longer administered to the patient (this can be problematic in diagnoses with a limited possibility of substituting one drug with another). That is why this topic is of great clinical importance and demonstrates the need for precise diagnosis of liver disease during in-patient care or the follow-up period.
Many tests must be repeated and the drug or food supplement history must be revised. In my paper, I describe the difficulties of correct DILI diagnosis and our own experiences with less frequent causes of liver test elevation, originally incorrectly diagnosed as a DILI.