BACKGROUND: Drugs and herbal products can induce autoimmune hepatitis. We assessed frequency and clinical outcomes of patients suffering from drug-induced autoimmune hepatitis. METHODS: All patients with drug-induced liver injury admitted between 2000 and 2011 were retrospectively studied. Diagnoses of drug-induced autoimmune hepatitis and idiopathic autoimmune hepatitis were made according to simplified criteria. After discharge, all patients had regular follow-up and were contacted to update outcomes. RESULTS: Among 10,270 in-hospital patients, 136 (1.3%) were diagnosed with drug-induced liver injury. Among them, 12 (8.8%) were diagnosed as drug-induced autoimmune hepatitis (41.7% males, age range 17-73); 8 (66.7%) were with jaundice at admission. Liver biopsies showed a pattern compatible with drug-induced autoimmune hepatitis, featured by severe portal inflammation and lymphoplasmacytic infiltrate. Drug-induced autoimmune hepatitis group had a shorter duration of drug intake, and higher values of transaminases and gamma globulins. All patients received immunosuppressive therapy with subsequent clinical remission, and five achieved a steroid-free long-term remission. CONCLUSIONS: A diagnosis of drug-induced autoimmune hepatitis was quite rare in our cohort, and clinical pattern was similar to idiopathic autoimmune hepatitis. Severe portal inflammation, prominent portal-plasma cells, rosette formation and severe focal necrosis were significantly more frequent in drug-induced autoimmune hepatitis as compared to drug-induced liver injury.
BACKGROUND: Drugs and herbal products can induce autoimmune hepatitis. We assessed frequency and clinical outcomes of patients suffering from drug-induced autoimmune hepatitis. METHODS: All patients with drug-induced liver injury admitted between 2000 and 2011 were retrospectively studied. Diagnoses of drug-induced autoimmune hepatitis and idiopathic autoimmune hepatitis were made according to simplified criteria. After discharge, all patients had regular follow-up and were contacted to update outcomes. RESULTS: Among 10,270 in-hospital patients, 136 (1.3%) were diagnosed with drug-induced liver injury. Among them, 12 (8.8%) were diagnosed as drug-induced autoimmune hepatitis (41.7% males, age range 17-73); 8 (66.7%) were with jaundice at admission. Liver biopsies showed a pattern compatible with drug-induced autoimmune hepatitis, featured by severe portal inflammation and lymphoplasmacytic infiltrate. Drug-induced autoimmune hepatitis group had a shorter duration of drug intake, and higher values of transaminases and gamma globulins. All patients received immunosuppressive therapy with subsequent clinical remission, and five achieved a steroid-free long-term remission. CONCLUSIONS: A diagnosis of drug-induced autoimmune hepatitis was quite rare in our cohort, and clinical pattern was similar to idiopathic autoimmune hepatitis. Severe portal inflammation, prominent portal-plasma cells, rosette formation and severe focal necrosis were significantly more frequent in drug-induced autoimmune hepatitis as compared to drug-induced liver injury.
Authors: Ynto S de Boer; Andrzej S Kosinski; Thomas J Urban; Zhen Zhao; Nanye Long; Naga Chalasani; David E Kleiner; Jay H Hoofnagle Journal: Clin Gastroenterol Hepatol Date: 2016-06-14 Impact factor: 11.382
Authors: Matthias Buechter; Paul Manka; Falko Markus Heinemann; Monika Lindemann; Hideo Andreas Baba; Martin Schlattjan; Ali Canbay; Guido Gerken; Alisan Kahraman Journal: World J Gastroenterol Date: 2018-04-07 Impact factor: 5.742
Authors: Chei Won Kim; Ji Sun Park; Se Hwan Oh; Jae-Hyung Park; Hyun-Ik Shim; Jae Woong Yoon; Jin Seok Park; Seong Bin Hong; Jun Mi Kim; Trong Binh Le; Jin Woo Lee Journal: Clin Mol Hepatol Date: 2016-05-20
Authors: Omar Yesid Martínez-Casas; Gabriel Sebastián Díaz-Ramírez; Juan Ignacio Marín-Zuluaga; Octavio Muñoz-Maya; Oscar Santos; Jorge Hernando Donado-Gómez; Juan Carlos Restrepo-Gutiérrez Journal: JGH Open Date: 2018-05-24