The liver is the most important metabolic organ of the human body, and most drugs are metabolized by the liver. Any liver injury caused by drugs or/and their metabolites during drug administration is called drug liver. Allergic reaction to drugs or drug specific reaction. It is an immune reaction of the body to drugs and metabolites or to complexes of drugs and metabolites covalently bound to macromolecules in the liver. This type of drug liver is unpredictable. Characteristics of immune-mediated atopic drug hepatitis Immune-mediated atopic drug hepatitis can be divided into allergic atopic drug hepatitis and autoimmune atopic drug hepatitis. Patients with allergic atopic drug hepatitis mainly present with hypersensitivity phenomena such as rapid onset (mostly within days to weeks of drug administration), fever, rash, arthralgia, often with eosinophilia, and autoantibody positivity is rare. Autoimmune mediated atopic drug hepatitis is characterized by a slow onset of injury (often occurring after several months of drug use), often with arthritis. positive for autoantibodies such as ANA and SMA, increased immunoglobulins, no eosinophilia or other allergic phenomena. The disease mainly affects young and middle-aged women. The timing of the onset of immune-mediated specific somatic drug-induced liver injury is also an important feature. It generally takes 1 to 3 months from the start of drug administration to the onset of DILI, which is exactly the time required for a general immune response to develop. Hypersensitivity reactions such as rash generally occur faster, while autoantibodies appear later (six months to one year). Most cases of drug-induced hepatitis recover rapidly from liver damage after drug discontinuation. However, in some cases, liver injury persists for a long time after drug discontinuation and the prognosis is poor. Most of these patients have autoimmune atopic drug hepatitis, in which the autoimmune response persists in the patient despite drug discontinuation. For immune-mediated atopic drug hepatitis, glucocorticoid therapy is effective. Complicated fulminant liver failure can be treated with artificial liver therapy.