Differential characteristics in drug-induced autoimmune hepatitis.

Autor: Martínez-Casas OY; Clinical Hepatology Universidad de Antioquia Medellín Colombia., Díaz-Ramírez GS; Clinical Hepatology Universidad de Antioquia Medellín Colombia., Marín-Zuluaga JI; Gastrohepatology Group Universidad de Antioquia Medellín Colombia.; Hepatology Unit and Hepatic Transplant Pablo Tobón Uribe Hospital Medellín Colombia., Muñoz-Maya O; Gastrohepatology Group Universidad de Antioquia Medellín Colombia.; Hepatology Unit and Hepatic Transplant Pablo Tobón Uribe Hospital Medellín Colombia., Santos O; Gastrohepatology Group Universidad de Antioquia Medellín Colombia.; Hepatology Unit and Hepatic Transplant Pablo Tobón Uribe Hospital Medellín Colombia., Donado-Gómez JH; Gastrohepatology Group Universidad de Antioquia Medellín Colombia.; Epidemiology Unit Pablo Tobón Uribe Hospital Medellín Colombia., Restrepo-Gutiérrez JC; Gastrohepatology Group Universidad de Antioquia Medellín Colombia.; Hepatology Unit and Hepatic Transplant Pablo Tobón Uribe Hospital Medellín Colombia.
Jazyk: angličtina
Zdroj: JGH open : an open access journal of gastroenterology and hepatology [JGH Open] 2018 May 24; Vol. 2 (3), pp. 97-104. Date of Electronic Publication: 2018 May 24 (Print Publication: 2018).
DOI: 10.1002/jgh3.12054
Abstrakt: Background and Aim: Drug-induced autoimmune hepatitis (DIAIH) is an adverse effect associated with several drugs that usually occurs acutely, with variable latency, and it may potentially be mortal. There are a few reports and studies about DIAIH.
Methods: This was an analytical study of a retrospective cohort of patients, discriminated according to idiopathic or drug-induced etiology, followed up for a 7-year period until 31 December 2016.
Results: A total of 190 patients were selected for the analysis, 12 (6.3%) with DIAIH. The two main drugs related to DIAIH were nitrofurantoin, n  = 8 (67%), and NSAID, n  = 2 (17%), constituting 84% of the cases. There were no significant differences in seropositivity between AIH with DIAIH in antinuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA) antibodies, with 82.6% versus 82.6% and 34% versus 16%, respectively. The fibrosis stages were similar, except for the F4 stage, in a greater proportion in AIH. None of the patients with DIAIH had cirrhosis or developed it during follow-up, but it was present in 42.1% of the AIH cases at diagnosis ( P  = 0.003). Biochemical remission with management was higher in DIAIH but not significant (91.7% vs 80.9%, P  = 0.35). The definitive interruption of immunosuppression was successfully performed in 25% of those with DIAIH without relapses but was only possible in 2.8% in AIH ( P  < 0.001) with 32 cases of relapses.
Conclusion: DIAIH constitutes a minor proportion of AIH. The clinical and histological characteristics may be similar; DIAIH patients have a greater chance of having treatment suspended with a low risk of relapse, progression to cirrhosis, or need for liver transplant.
Databáze: MEDLINE
Externí odkaz: