What is the Origin of Idiosyncratic Liver Injury?

Idiosyncratic is derived from the Greek idios (one's own) and synkrasis (temperament or mixing), emphasizing the individual-specific nature of the reaction. The term belongs to the field of pharmacovigilance and toxicology, distinguishing this rare form of liver damage from common, dose-related hepatotoxicity.

What is the Mechanism of Idiosyncratic Liver Injury?

The precise mechanism is complex and not fully understood, but it is generally hypothesized to involve two main pathways. In the metabolic-immune mechanism, a drug is metabolized into a reactive, toxic intermediate that covalently binds to hepatocyte proteins, triggering an immune-mediated inflammatory response. Alternatively, a drug may directly interfere with mitochondrial function, leading to oxidative stress and subsequent cell death, demonstrating a susceptibility unique to the individual's genetic and metabolic profile.

Idiosyncratic Liver Injury ∞ Area

Idiosyncratic Liver Injury

Meaning

Idiosyncratic Liver Injury (ILI) is a rare, unpredictable, and often severe adverse hepatic reaction to a pharmaceutical agent that is not dose-dependent and is unrelated to the drug’s known pharmacological mechanism. Unlike predictable, intrinsic hepatotoxicity, ILI is believed to be mediated by host-specific factors, such as genetic polymorphisms or immune system hypersensitivity. It represents a significant challenge in drug safety and clinical hepatology due to its low incidence and difficulty in prediction.