Digestive Diseases and Sciences

, Volume 52, Issue 2, pp 594–597 | Cite as

Methylphenidate-Induced Autoimmune Hepatitis

  • Jason J. Lewis
  • Julia C. Iezzoni
  • Carl L. Berg
Case Report


Autoimmune hepatitis (AIH) is a chronic necroinflammatory disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level [1]. The pathogenesis is proposed to result from a genetically predisposed host being exposed to an environmental agent that triggers an autoimmune process directed at liver antigens causing continued inflammation that results in fibrosis and often cirrhosis [1]. The diagnosis is characterized by serologic markers such as antinuclear antibodies (ANAs), anti-smooth muscle antibody (anti-SMA), antiactin antibody, anti-liver/kidney microsomal antibody (anti-LKMA), and elevated serum globulins, most notably immunoglobulin G (IgG) [1]. Anti-inflammatory/immunosuppressive therapy is effective, with an initial remission rate of 80%, with prognosis inversely proportional to histologic severity of disease [1].

Many pharmacological agents have been suspected as triggering agents for AIH including methyldopa, nitrofurantoin,...


Autoimmune hepatitis Methylphenidate Liver transplantation 


  1. 1.
    Krawitt EL (2006) Autoimmune hepatitis. N Engl J Med 354:54–66PubMedCrossRefGoogle Scholar
  2. 2.
    Lewis JH, Zimmerman H (1998) Drug induced autoimmune liver disease. In: Krawitt EL, Wiesner RH, Nishioka M (eds) Autoimmune liver disease, 2nd ed. Elsevier, Amsterdam, pp 627–649Google Scholar
  3. 3.
    Nietsch HH, et al. (2000) Minocycline-induced hepatitis. Am J Gastroenterol 95:2993–2994PubMedCrossRefGoogle Scholar
  4. 4.
    Alla, V, et al. (2006) Autoimmune hepatitis triggered by statins. J Clin Gastroenterol 40:757--761Google Scholar
  5. 5.
    Sterling MJ, Kane M, Grace N (1996) Pemoline-induced autoimmune hepatitis. Am J Gastroenterol 91(10):2233–2234PubMedGoogle Scholar
  6. 6.
    Challman TD, Lipsky J (2000) Methylphenidate: its pharmacology and uses. Mayo Clin Proc 75(7):711–721PubMedCrossRefGoogle Scholar
  7. 7.
    Bader GM, Hawley J, Short D (1998) Venlafaxine augmentation with methylphenidate for treatment refractory depression: A case report. J Clin Psychopharm 18(3):255–256CrossRefGoogle Scholar
  8. 8.
    Plutchik L, Snyder S, Drooker M, et al. (1998) Methylphenidate in post-liver transplant patients. Psychosomatics 39:118–123PubMedGoogle Scholar
  9. 9.
    Kalant, H (2001) The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. Can Med Assoc J 165(7):917–928Google Scholar
  10. 10.
    Maurer HH, et al. (2004) Chemistry, pharmacology, toxicology and hepatic metabolism of designer drugs of the amphetamine (Ecstasy), piperazine, and pyrrolidinophenone types; a synopsis. Ther Drug Monit 26(2):127–131PubMedCrossRefGoogle Scholar
  11. 11.
    Jones AL, Simpson K (1999) Review article: Mechanisms and management of hepatotoxicity in ecstasy (MDMA) and amphetamine intoxications. Aliment Pharmacol Ther 13(2):129–133PubMedCrossRefGoogle Scholar
  12. 12.
    Lyseng-Williamson KA, Keating GM (2002) Extended-release methylphenidate. Drugs 62(15):2251–2259PubMedCrossRefGoogle Scholar
  13. 13.
    Goodman CR (1972) Hepatotoxicity due to methylphenidate hydrochloride. NY State J Med 72(18):2339–2340Google Scholar
  14. 14.
    Mehta H, Murray B, Loludice T (1984) Hepatic dysfunction due to intravenous abuse of methylphenidate hydrochloride. J Clin Gastroenterol 6:149–151PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • Jason J. Lewis
    • 1
  • Julia C. Iezzoni
    • 2
  • Carl L. Berg
    • 3
  1. 1.Department of Internal MedicineUniversity of Virginia Health SystemCharlottesvilleUSA
  2. 2.Department of PathologyUniversity of Virginia Health SystemCharlottesvilleUSA
  3. 3.Division of Gastroenterology and HepatologyUniversity of Virginia Health SystemCharlottesvilleUSA

Personalised recommendations