Open AccessDifferential characteristics in drug‐induced autoimmune hepatitis
Author(s) -
MartínezCasas Omar Yesid,
DíazRamírez Gabriel Sebastián,
MarínZuluaga Juan Ignacio,
MuñozMaya Octavio,
Santos Oscar,
DonadoGómez Jorge Hernando,
RestrepoGutiérrez Juan Carlos
Publication year - 2018
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12054
Subject(s) - medicine , autoimmune hepatitis , gastroenterology , anti nuclear antibody , drug , azathioprine , hepatitis , immunosuppression , drug withdrawal , retrospective cohort study , etiology , cirrhosis , nitrofurantoin , antibody , immunology , autoantibody , disease , pharmacology , antibiotics , ciprofloxacin , biology , microbiology and biotechnology
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.