R factor ＞ 5 : Hepatocellular injury pattern
R factor 2 ~ 5 : Mixed injury pattern
R factor ＜ 2 : Cholestatic injury pattern
Am J Gastroenterol 2014; 109:950–966;
An algorithm to evaluate suspected idiosyncratic drug-induced liver injury (DILI). The R -value cutoff numbers of 2 and 5 serve only as a guideline. Which tests and their order must be based on the overall clinical picture including risk factors for competing diagnosis (e.g., recent travel to hepatitis E virus (HEV) endemic area), associated symptoms (e.g., abdominal pain, fever), and timing of laboratory tests (i.e., the R -value may change as the DILI evolves). ALT, alanine aminotransferase; Alk P, alkaline phosphatase; CMV, cytomegalovirus; EBV, Epstein – Barr virus; HCV, hepatitis C virus; HSV, herpes simplex virus; MR, magnetic resonance; ULN, upper limit of normal. (Am J Gastroenterol 2014; 109:950–966;)
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