Por favor, use este identificador para citar o enlazar este ítem: https://hdl.handle.net/20.500.12008/52979

Título:

Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries

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Autor:

García-Cortés, Miren
Ortega-Alonso, Aida
Matilla-Cabello, Gonzalo
Medina-Cáliz, Inmaculada
Castiella, Agustín
Conde, Isabel
Bonilla-Toyos, Elvira
Pinazo-Bandera, José
Hernández, Nelia
Tagle, Martín
Nunes, Vinicius
Parana, Raymundo
Bessone, Fernando
Kaplowitz, Neil
Lucena, M. Isabel
Alvarez-Alvarez, Ismael
Robles-Díaz, Mercedes
Andrade, Raúl J.

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Tipo de documento:

Artículo

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Palabras clave:

Autoimmune features
Autoimmune hepatitis
Drug-induced autoimmune-like hepatitis
Drug-induced liver injury
Hepatotoxicity

Descriptores:

BILIRRUBINA
ENFERMEDAD HEPÁTICA INDUCIDA POR SUSTANCIAS Y DROGAS
EPIDEMIOLOGÍA
HUMANOS
MUJERES
HEPATITIS AUTOINMUNE
QUIMIOTERAPIA
ESTUDIOS PROSPECTIVOS
TRANSAMINASAS
SISTEMA DE REGISTROS

Año de publicación:

2023

Contenido:

Resumen:

Background & aims: Idiosyncratic drug-induced liver injury (DILI) with autoimmune features is a liver condition with laboratory and histological characteristics similar to those of idiopathic autoimmune hepatitis (AIH), which despite being increasingly reported, remains largely undefined. We aimed to describe in-depth the features of this entity in a large series of patients from two prospective DILI registries. Methods: DILI cases with autoimmune features collected in the Spanish DILI Registry and the Latin American DILI Network were compared with DILI patients without autoimmune features and with an independent cohort of patients with AIH. Results: Out of 1,426 patients with DILI, 33 cases with autoimmune features were identified. Female sex was more frequent in AIH patients than in the other groups (p = .001). DILI cases with autoimmune features had significantly longer time to onset (p < .001) and resolution time (p = .004) than those without autoimmune features. Interestingly, DILI patients with autoimmune features who relapsed exhibited significantly higher total bilirubin and transaminases at onset and absence of peripheral eosinophilia than those who did not relapse. The likelihood of relapse increased over time, from 17% at 6 months to 50% 4 years after biochemical normalization. Statins, nitrofurantoin and minocycline were the drugs most frequently associated with this phenotype. Conclusions: DILI with autoimmune features shows different clinical features than DILI patients lacking characteristics of autoimmunity. Higher transaminases and total bilirubin values with no eosinophilia at presentation increase the likelihood of relapse in DILI with autoimmune features. As the tendency to relapse increases over time, these patients will require long-term follow-up.

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Editorial:

Wiley

EN:

Liver International. 2023;43(8):1749-1760

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Citación:

García-Cortés M, Ortega-Alonso A, Matilla-Cabello G y otros. Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries. Liver International [en línea]. 2023;43(8):1749-1760

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1478-3231

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Licencia Creative Commons Atribución - No Comercial (CC - By-NC 4.0)

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