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.

Licata, A., Maida, M., Cabibi, D., Butera, G., Macaluso, F., Alessi, N., et al. (2014). Clinical features and outcomes of patients with drug-induced autoimmune hepatitis: A retrospective cohort study. DIGESTIVE AND LIVER DISEASE, 46, 1116-1120 [10.1016/j.dld.2014.08.040].

Clinical features and outcomes of patients with drug-induced autoimmune hepatitis: A retrospective cohort study.

LICATA, Anna;CABIBI, Daniela;MACALUSO, Fabio Salvatore;ALESSI, Nicola;CARUSO, Calogero;CRAXI, Antonio;ALMASIO, Pier Luigi
2014-01-01

Abstract

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.
2014
Settore MED/08 - Anatomia Patologica
Settore MED/12 - Gastroenterologia
Settore MED/04 - Patologia Generale
Licata, A., Maida, M., Cabibi, D., Butera, G., Macaluso, F., Alessi, N., et al. (2014). Clinical features and outcomes of patients with drug-induced autoimmune hepatitis: A retrospective cohort study. DIGESTIVE AND LIVER DISEASE, 46, 1116-1120 [10.1016/j.dld.2014.08.040].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/97962
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