Abstract: Objective To investigate the efficacy and safety of glucocorticoid in treatment of severe drug-induced liver injury (DILI). Methods Thirty-seven patients with severe DILI were divided into control group (n=21) and glucocorticoid group (n=16), who received only conventional therapy and conventional therapy plus small dose of glucocorticoid in short course, respectively. Results In glucocorticoid group, levels of alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBil), direct bilirubin (DB) and alkaline phosphatase (ALP) were significantly decreased at week 2 (93.2±65.6; 61.7±30.7; 168.3±98.9; 124.7±81.4; 117.2±40.1) and week 4 (52.6±32.0; 77.4±144.1; 88.9±59.7; 64.7±48.4; 116.6±63.1) after treatment compared to those in baseline (172.9±104.8; 264.7±169.7; 259.1±108.8; 182.2±82.4; 153.8±69.9), respectively (P<0.05). In control group, ALT and AST levels were significantly lower at week 2 (P<0.05), and the serum levels of TB and DB decreased significantly at week 4 (P<0.05). The efficiency and effectiveness of treatment in glucocorticoid group were significantly higher than those in control group (93.8% vs 66.7%, χ²=11.919, P=0.001; 87.5% vs 57.1%, χ²=6.081, P=0.014). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Early medication of small dose glucocorticoid with short course might be effective and safe for severe DILI.

Key words: Drug-induced liver injury, Cholestasis, Glucocorticoid