Open AccessAtovaquone/proguanil‐induced autoimmune‐like hepatitis
Author(s) -
Terziroli BerettaPiccoli Benedetta,
MieliVergani Giorgina,
Bertoli Raffaela,
Mazzucchelli Luca,
Nofziger Charity,
Paulmichl Markus,
Vergani Diego
Publication year - 2017
Publication title -
hepatology communications
Language(s) - English
Resource type - Journals
ISSN - 2471-254X
DOI - 10.1002/hep4.1039
Subject(s) - atovaquone , medicine , autoimmune hepatitis , hepatology , hepatitis , drug , proguanil , liver disease , gastroenterology , immunology , pharmacology , malaria , chloroquine , plasmodium falciparum
We report a novel association between the commonly used antimalarial medication atovaquone/proguanil and drug‐induced autoimmune‐like hepatitis. The patient developed severe liver disease fulfilling biochemical, immunologic, and histologic criteria for the diagnosis of autoimmune hepatitis after the inadvertent rechallenge with the offending drug, which had caused self‐limited hepatitic symptoms a year previously. Over a period of 18 months, the patient underwent two follow‐up liver biopsies showing progressive resolution of the liver inflammation and achieved complete biochemical and immunologic remission on steroids. This remission persisted for 20 months following treatment withdrawal. Conclusion : This well documented case raises awareness of the potential hepatotoxicity of atovaquone/proguanil. ( Hepatology Communications 2017;1:293–298)