Drug-induced liver disease is of great importance because it is the leading cause of acute liver failure (ALF) in the United States. It is also a major reason for withdrawal of drugs during drug development and clinical use. The latter has major medical and economic consequences, as reflected in the recent experiences when bromfenac and troglitazone were withdrawn from the market. Because drug-induced liver disease can mimic the entire spectrum of clinicopathologic features of other acute and chronic liver diseases, it is often challenging to diagnose. Establishing causality is important because the treatment of drug-induced liver disease includes discontinuation of the offending drug.
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