Drug-Induced Liver Injury with Autoimmune Features

作者：deLemos Andrew S^*; Foureau David M; Jacobs Carl; Ahrens Will; Russo Mark W; Bonkovsky Herbert L

来源：Seminars in Liver Disease, 2014, 34(2): 194-204.

DOI：10.1055/s-0034-1375959

• drug-induced liver injury
• autoimmune-hepatitis
• autoantibodies
• autoimmunity

Drug-induced liver injury (DILI) With features of autoimmunity (AI) represents an important category of hepatotoxicity due to medication exposure. Drugs repeatedly associated with AI-DILI include diclofenac, alpha-methyl. DOPA,hydralazine, nitrofurantoin, minocycline; and more recently statins and anti-TNF-alpha agents. Usually, symptoms of acute liver injury occur within a few months-after initiation-of a culprit medication, but a longer latency period is possible. Like idiopathic autoimmune hepatitis, circulating autoantibodies and a hypergammaglobulinemia are frequently present in sera. from patients with AI-DILI. If-performed, a liver biopsy shoulds dem:onstrate interface hepatitis with a prominent plasma-tell infiltrate. The severity of AI-DILI is variable, but a complete resolution after withdrawal of the offending medication is the expectation. A response to corticosteroid therapy supports the diagnosis, whereas a lack of recurrence of symptoms. or signs following corticosteroid cessation distinguishes. AI-DILI from idiopathic autoimmune hepatitis.

• 出版日期2014-5