Resumen
Introduction: Drug-induced liver injury has several phenotypes, among which autoimmune hepatitis is an emerging one. This presents serological and/or histological markers of idiopathic autoimmune hepatitis, making this phenotype a diagnostic challenge. Case description: A 24-year-old female patient who received treatment with nitrofurantoin presented pain in the right hypochondrium and jaundice 5 days after starting treatment, accompanied by an increase in transaminases, alkaline phosphatase and total bilirubin. In the absence of other alternative causes to explain the abnormalities, immunological tests and a liver biopsy were performed, which were compatible with autoimmune hepatitis. After 5 days of treatment with corticosteroids, liver tests decreased significantly and without relapse when treatment was discontinued. Conclusion: Recognizing drug-induced liver injury and this emerging phenotype is crucial, as failure to differentiate between it and idiopathic autoimmune hepatitis can result in adverse outcomes for the patient.
Citas
Andrade, R.J., Chalasani, N., Björnsson, E.S., Suzuki, A., Kullak-Ublick, G.A., Watkins, P.B., et al. Drug-induced liver injury. Nat Rev Dis Primers. 2019, Dec.; 5(1): 58. DOI: 10.1038/s41572-019-0105-0
Andrade, R.J., Aithal, G.P., de Boer, Y.S., Liberal, R., Gerbes, A., Regev, A., et al. Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report. Journal of Hepatology. 2023, Sept.; 79(3): 853-866. DOI: 10.1016/j.jhep.2023.04.033
Yang X, Sohnen A. Nitrofurantoin-induced autoimmune hepatitis. Abstracts from the 2021 Annual Meeting of the Society of General Internal Medicine. J Gen Intern Med. 2021; 36(Suppl 1); S1-S469. DOI: 10.1007/s11606-021-06830-5
Chalasani, N., Li, Y.J., Dellinger, A., Navarro, V., Bonkovsky, H., Fontana, R.J., et al. Clinical features, outcomes, and HLA risk factors associated with nitrofurantoin-induced liver injury. J Hepatol. 2023, Feb.; 78(2): 293-300. DOI: 10.1016/j.jhep.2022.09.010 .
Hosack, T., Damry, D., Biswas, S. Drug-induced liver injury: a comprehensive review. Therap Adv Gastroenterol. 2023, March; 16. DOI: 10.1177/17562848231163410
Chalasani, N.P., Maddur, H., Russo, M.W., Wong, R.J., Reddy, K.R. ACG Clinical Guideline: Diagnosis and Management of Idiosyncratic Drug-Induced Liver Injury. Am J Gastroenterol. 2021, May; 116(5): 878-898. DOI: 10.14309/ajg.0000000000001259
Björnsson, E.S., Medina-Caliz, I., Andrade, R.J., Lucena, M.I. Setting up criteria for drug-induced autoimmune-like hepatitis through a systematic analysis of published reports. Hepatol Commun. 2022, Aug.; 6(8): 1895-1909. DOI: 10.1002/hep4.1959
Björnsson, H.K., Björnsson, E.S. Drug-induced liver injury: Pathogenesis, epidemiology, clinical features, and practical management. Eur J Intern Med. 2022, Mar.; 97: 26-31. DOI: 10.1016/j.ejim.2021.10.035
Božić, D., Tonkić Jr, A., Vukojevic, K., Radman, M. A Case Report: Idiopathic or Drug-Induced Autoimmune Hepatitis—Can We Draw a Line? Clin Pract. 2023, Dec.; 13(6): 1393–1399. DOI: 10.3390/clinpract13060125
Björnsson, E.S. Clinical management of patients with drug-induced liver injury (DILI). United European Gastroenterol J. 2021, Sep.; 9(7): 781-786. DOI: 10.1002/ueg2.12113
Bessone, F., Ferrari, A., Hernández. N., Mendizábal, M., Ridruejo, E., Zerega, A., et al. Nitrofurantoin-induced liver injury: long-term follow-up in two prospective DILI registries. Arch Toxicol. 2023, Feb.; 97(2): 593-602. DOI: 10.1007/s00204-022-03419-7
Castiella, A., Lucena, M.I., Zapata, E.M., Otazua, P., Andrade, R.J. Drug-induced autoimmune-like hepatitis: A diagnostic challenge. Dig Dis Sci. 2011, Aug.; 56(8): 2501-2502. DOI: 10.1007/s10620-011-1787-7
deLemos, A.S., Foureau, D.M., Jacobs, C., Ahrens, W., Russo, M.W., Bonkovsky, H.L. Drug-induced liver injury with autoimmune features. Semin Liver Dis. 2014, May; 34(2): 194-204. DOI: 10.1055/s-0034-1375959
Björnsson, E.S., Vucic, V., Stirnimann, G., Robles-Díaz, M. Role of Corticosteroids in Drug-Induced Liver Injury. A Systematic Review. Front Pharmacol. 2022, Feb. DOI: 10.3389/fphar.2022.820724
Castiella, A., Zapata, E., Lucena, M.I., Andrade, R.J. Drug-induced autoimmune liver disease: A diagnostic dilemma of an increasingly reported disease., World J Hepatol. 2014, April; 6(4): 160-168. DOI: 10.4254/wjh.v6.i4.160
Hisamochi, A., Kage, M., Ide, T., Arinaga-Hino, T., Amano, K., Kuwahara, R., et al. An analysis of drug-induced liver injury, which showed histological findings similar to autoimmune hepatitis. J Gastroenterol. 2016, Jun.; 51(6): 597-607. DOI: 10.1007/s00535-015-1131-7
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Copyright (c) 2024 Maria Fernanda Garcia Gonzalez, Paulo Cesar Marroquín Mijangos , Joselyn Aracely Alvarez-Meza
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