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Abbreviations used in this paper: CIOMS, Council for International Organizations of Medical Sciences; DILI, drug-induced liver injury; DILIN, Drug
Induced Liver Injury Network; FDA, Food and Drug Administration; GTE,
green tea extract; HDS, herbal and dietary supplements; HILI, HDSinduced liver injury; RUCAM, Roussel Uclaf Causality Assessment Method.
2014 by the AGA Institute
1542-3565/$36.00
http://dx.doi.org/10.1016/j.cgh.2013.07.030
July 2014
Temporal relationship
Course after discontinuation
Specic to liver injury
Hepatitis vs Cholestatic
Risk factorsa
Age of patient
Extrahepatic manifestations
Placebo challenge
Reported toxicity history
Rechallenge
Dose effect
Interobserver correlation
RUCAM/CIOMS23
Naranjo25
DILIN31
Yes
Yes
Yes
Yes
Yes
Yes
No
No
Yes
Yes
No
No
Yes
Yes
Yes
No
Yes
No
Yes
No
Yes
Yes
No
No
Yes
Yes
No
No
Yes
No
No
Yes
No
Yes
Yes
No
Yes
Yes
Yes
No
Yes
No
No
No
Yes
Yes
No
Yes
Bodybuilding Supplements
Anabolic steroids. In an effort to limit their access,
anabolic steroids were classied as Class III controlled
substances in 1991, and their control was further
expanded in 2004.112 Their potential hepatotoxicity was
recognized early on with the observation of a link between anabolic androgenic steroids and jaundice and
July 2014
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Reprint requests
Address requests for reprints to: Simona Rossi, MD, Division of Hepatology,
Einstein Medical Center Philadelphia, Klein Professional Building Suite 505,
5401 Old York Road, Philadelphia, Pennsylvania 19141. e-mail: rossisim@
einstein.edu; fax: (215) 456-8058.
Conicts of interest
The authors disclose no conicts.