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 R oussel U claf C ausality A ssessment M ethod score of 10 and a J apan D igestive D isease W eek 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 .