Assessment of 287 Japanese cases of drug induced liver injury by the diagnostic scale of the International Consensus Meeting.

Two hundred and eighty seven Japanese cases of drug induced liver injury were assessed by the diagnostic scale of the International Consensus Meeting (ICM). They were classified to the hepatocellular (55%), mixed (24%) and cholestatic (22%) type according to the type of liver injury. Five cases were diagnosed as 'unrelated', since the reaction occurred more than 15 days after stopping the drug. The remaining 282 cases were classified to 69 cases of 'highly probable', 170 cases of 'probable', 39 cases of 'possible', and four cases of 'unlikely'. The cases with positive drug-lymphocyte stimulation test (DLST) and with eosinophilia distributed to higher scores. Although the diagnostic scale of the ICM was found to be also useful for Japanese cases, the modification of the scale including the data of DLST and eosinophilia together with some other modifications were recommended in the view of the present status of Japan. Using the modified diagnostic scale, the 287 cases were classified to 173 cases of 'highly probable', 102 cases of "probable', 11 cases of 'possible', and one case of 'unlikely'. Although the modified diagnostic scale seems better than the original one, further assessment of the modified scale using many Japanese cases is needed for the further improvement of the scale.