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Autoimmune Hepatitis-Induced by Drugs: a Challenging Diagnosis

  • Drug-Induced Liver Injury (F Bessone and R Andrade, Section Editors)
  • Published:
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Abstract

Purpose of Review

The aim of the current review is to perform an analysis of data in recent years that might be helpful to distinguish between autoimmune hepatitis (AIH) and drug-induced autoimmune hepatitis (DIAIH).

Recent Findings

Well-established drugs leading to DIAIH have been shown to be hydralazine, methyldopa, minocycline, and nitrofurantoin. More recently anti-TNF-alpha antagonists have been increasingly reported to lead to DIAIH, most commonly infliximab, DIAIH can be defined as drug-induced liver injury (DILI) with the presence of ANA and/or SMA and elevated IgG. Histology has not been shown to be valuable to predict requirement of corticosteroids. The new simplified criteria for AIH have not been shown to predict requirement of steroids. Corticosteroids should be considered in patients who do not show improvement in ALT after discontinuation of the implicated agent.

Summary

Lack of relapse after discontinuation of corticosteroids seems to distinguish between DIAIH patients and those with classical AIH. has been show nto be one of the most common cause of DIAIH nowadays.

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Acknowledgments

To Jon G. Jonasson, Professor of pathology, at Landspitali University Hospital Iceland, for the histological figure.

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Authors and Affiliations

  1. Faculty of Medicine, University of Iceland, Reykjavík, Iceland

    Einar S. Björnsson

  2. Department of Internal Medicine and Division of Gastroenterology and Hepatology, Faculty of Medicine, The National University Hospital of Iceland, Hringbraut 101, Reykjavik, Iceland

    Einar S. Björnsson

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Correspondence to Einar S. Björnsson.

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Einar S. Björnsson declares no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Drug-Induced Liver Injury

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Björnsson, E.S. Autoimmune Hepatitis-Induced by Drugs: a Challenging Diagnosis. Curr Hepatology Rep 16, 265–270 (2017). https://doi.org/10.1007/s11901-017-0365-7

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