Weber S, et al. - Forty-four subjects with an acute liver injury who took at least one drug and who received corticosteroids were involved, comprising of 22 drug-induced liver injury (DILI) and 22 autoimmune hepatitis (AIH) cases by experts in order to recognize a simple parameter to discriminate DILI and AIH shortly after beginning corticosteroid treatment. Alterations in the serum alanine aminotransferase (ALT) concentrations after beginning corticosteroid treatment were discovered and contrasted among the DILI and AIH groups. Nearly 59% of subjects (n=26) were correctly classified at the presentation by AIH score and RUCAM, respectively. Nevertheless, in one third (n=13) of the 44 subjects, results were inconclusive and five other cases were misclassified. In cases with the final diagnosis of DILI vs AIH cases, the reduction in ALT levels one week following the initiation of steroid therapy was significantly more pronounced. In the 18 initially misclassified or inconclusive cases, this variation was also noted. Hence, in order to distinguish DILI and AIH, the short-term response of ALT to corticosteroid therapy helped. Moreover, for subjects with inconclusive diagnostic scores, the conclusion may be beneficial in treatment decisions.