Comparison of Liver Biopsy Findings with the Digestive Disease Week Japan 2004 Scale for Diagnosis of Drug-Induced Liver Injury
Table 1
(a) Comparison between DDW-J and CIOMS/RUCAM scales for drug-induced liver injury (DILI). (b) Time to onset: hepatocellular type. (c) Time to onset: cholestatic type.
(a)
Scales
DDW-J
CIOMS/RUCAM
Score
Time to onset
0 to +2
0 to +2
Course of the reaction
−2 to +3
−2 to +3
Risk factor
Age
0 to +1
Alcohol, pregnancy
0 to +1
0 to +1
Comedication
−3 to 0
Other causes
−3 to +2
−3 to +2
Previous information on hepatotoxicity
0 to +1
0 to +2
Eosinophilia
0 to +1
Drug-lymphocyte stimulation test
0 to +2
Response to readministration
−2 to +3
−2 to +3
Thresholds
Highly probable
>8
Probable
≧5
6 to 8
Possible
3 to 4
3 to 5
Unlikely
≦2
1 to 2
Excluded
≦0
Score +2: all causes in groups I and II are ruled out. Score +1: all causes in group I are ruled out. Score 0: 5 or 4 causes in group I are ruled out. Score −1: less than 4 causes in group I are ruled out. Score −2: less than 3 causes in group I are ruled out. Score −3: nondrug cause highly probable. Group I: HAV, HBV, HCV, biliary obstruction, alcoholism, and acute recent hypotension history. Group II: cytomegalovirus and Epstein-Barr virus.
(b)
Suggestive from onset of drug administration (score +2)
Compatible (score +1)
Incompatible (score 0)
From onset of drug administration
From cessation of drug administration
From onset of drug administration
From cessation of drug administration
Initial treatment
5–90 days
<5 or >90 days
≦15 days
—
>15 days
Subsequent treatment
1–15 days
>15 days
≦15 days
—
>15 days
(c)
Suggestive from onset of drug administration (score +2)
