BACKGROUND Nonsteroidal anti-inflammatory drugs (NSAIDs) are a leading cause of drug-induced liver injury (DILI) across the world. Ibuprofen is one of the most commonly used and safest NSAIDs, nevertheless reports on ibuprofen-induced hepatotoxicity are available. AIM To analyse previously published information on ibuprofen-induced liver injury for a better characterisation of its phenotypic expression. METHOD A systematic search was performed and information on ibuprofen-induced liver injury included in case series and case reports, in terms of demographic, clinical, biochemical and outcome data, was analysed. RESULTS Twenty-two idiosyncratic ibuprofen hepatotoxicity cases were identified in the literature, suggesting a very low prevalence of this type of DILI. These patients had a mean age of 31 years and 55% were females. Mean cumulative dose of ibuprofen and time to onset were 30 g and 12 days, respectively. Hepatocellular injury was the most frequently involved liver injury pattern. Six cases developed vanishing bile duct syndrome. Full recovery occurred in 11 patients after a mean time of 14 weeks, whereas five cases evolved to acute liver failure leading to death/liver transplantation. CONCLUSIONS When assessing potential hepatotoxicity cases, physicians should keep in mind that ibuprofen has been associated with hepatotoxicity in the literature. Ibuprofen-associated DILI presents commonly as hepatocellular damage after a short latency period. Published reports on ibuprofen hepatotoxicity leading to liver failure resulting in liver transplantation or death are available. However, due to the apparent low absolute risk of ibuprofen-induced liver complications, ibuprofen can be regarded as an efficacious and safe NSAID.

中文翻译：

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系统评价：布洛芬引起的肝损伤。

背景技术非甾体抗炎药（NSAID）是世界范围内药物诱导的肝损伤（DILI）的主要原因。布洛芬是最常用和最安全的非甾体类抗炎药之一，尽管如此，有关布洛芬诱导的肝毒性的报道已有报道。目的分析先前发表的有关布洛芬诱导的肝损伤的信息，以更好地表征其表型表达。方法进行了系统的搜索，并从人口统计学，临床，生化和结局数据方面分析了病例系列和病例报告中有关布洛芬诱发的肝损伤的信息。结果在文献中确定了22例特发性布洛芬肝毒性病例，这表明这种DILI的患病率非常低。这些患者的平均年龄为31岁，女性为55％。布洛芬的平均累积剂量和发作时间分别为30 g和12天。肝细胞损伤是最常见的肝损伤类型。六例发展为消失的胆管综合症。在平均14周的时间后，有11名患者完全康复，而有5例演变为急性肝衰竭导致死亡/肝移植。结论在评估潜在的肝毒性病例时，医生应记住，布洛芬与文献中的肝毒性有关。在短暂的潜伏期后，布洛芬相关的DILI通常表现为肝细胞损伤。关于布洛芬导致肝功能衰竭导致肝移植或死亡的肝毒性的已发表报告已有报道。但是，由于布洛芬诱发的肝脏并发症的绝对风险明显较低，