Elevation of serum cytokines preceding elevation of liver enzymes in a case of drug‐induced liver injury

A 50-year-old man who was being treated for both pneumonia and type 2 diabetes mellitus complained of abdominal distention on the 16th hospital day. Liver enzyme elevation without symptoms was detected on the 17th hospital day. Based on a Roussel Uclaf Causality Assessment Method score of 10 and a Japan Digestive Disease Week score of 9, we diagnosed the patient as having drug-induced liver injury (DILI). Simultaneous assays of the levels of cytokines revealed that the elevation of the levels of interleukin (IL)-1β, IL-10, IL-12, IL-13 and tumor necrosis factor-α preceded the elevation of the serum liver enzymes. This case suggests that some cytokines or related molecules are potentially useful as early-phase biomarkers for DILI.