Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries
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 aim...
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2023
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| author | Miren García‐Cortés Aida Ortega‐Alonso Gonzalo Matilla‐Cabello Inmaculada Medina‐Cáliz Agustín Castiella Isabel Conde Elvira Bonilla‐Toyos José M. Pinazo-Bandera Nelia Hernández Martín Tagle Vinícius Nunes Raymundo Paraná Fernando Bessone Neil Kaplowitz M. Isabel Lucena Ismael Álvarez‐Álvarez Mercedes Robles‐Díaz Raúl J. Andrade |
| author_browse | Agustín Castiella Aida Ortega‐Alonso Elvira Bonilla‐Toyos Fernando Bessone Gonzalo Matilla‐Cabello Inmaculada Medina‐Cáliz Isabel Conde Ismael Álvarez‐Álvarez José M. Pinazo-Bandera M. Isabel Lucena Martín Tagle Mercedes Robles‐Díaz Miren García‐Cortés Neil Kaplowitz Nelia Hernández Raymundo Paraná Raúl J. Andrade Vinícius Nunes |
| author_facet | Miren García‐Cortés Aida Ortega‐Alonso Gonzalo Matilla‐Cabello Inmaculada Medina‐Cáliz Agustín Castiella Isabel Conde Elvira Bonilla‐Toyos José M. Pinazo-Bandera Nelia Hernández Martín Tagle Vinícius Nunes Raymundo Paraná Fernando Bessone Neil Kaplowitz M. Isabel Lucena Ismael Álvarez‐Álvarez Mercedes Robles‐Díaz Raúl J. Andrade |
| author_sort | Miren García‐Cortés |
| collection | Producción científica |
| description | 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. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/1070 |
| institution | UPeU |
| language | English |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/10702026-10-30T16:15:10ZClinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registriesMiren García‐CortésAida Ortega‐AlonsoGonzalo Matilla‐CabelloInmaculada Medina‐CálizAgustín CastiellaIsabel CondeElvira Bonilla‐ToyosJosé M. Pinazo-BanderaNelia HernándezMartín TagleVinícius NunesRaymundo ParanáFernando BessoneNeil KaplowitzM. Isabel LucenaIsmael Álvarez‐ÁlvarezMercedes Robles‐DíazRaúl J. AndradeAutoimmune hepatitisMedicineInternal medicineEosinophiliaProspective cohort studyAutoimmunityImmunologyGastroenterologyHepatitisDiseaseAutoimmune hepatitisMedicineInternal medicineEosinophiliaProspective cohort studyAutoimmunityImmunologyGastroenterologyHepatitisDiseaseTransaminasesTransaminasesTransaminasesTransaminasesBilirubinBilirubinBilirubinBilirubinFemaleFemaleFemaleFemaleHumansHumansHumansHumansProspective StudiesProspective StudiesProspective StudiesProspective StudiesRegistriesRegistriesRegistriesRegistriesHepatitis, Autoimmune drug therapyHepatitis, Autoimmune drug therapyHepatitis, Autoimmune drug therapyHepatitis, Autoimmune drug therapyHepatitis, Autoimmune epidemiologyHepatitis, Autoimmune epidemiologyHepatitis, Autoimmune epidemiologyHepatitis, Autoimmune epidemiologyChemical and Drug Induced Liver Injury etiologyChemical and Drug Induced Liver Injury etiologyChemical and Drug Induced Liver Injury etiologyChemical and Drug Induced Liver Injury etiologyChemical and Drug Induced Liver Injury epidemiologyChemical and Drug Induced Liver Injury epidemiologyChemical and Drug Induced Liver Injury epidemiologyChemical and Drug Induced Liver Injury epidemiologyLife Sciences Pharmacology, Toxicology and Pharmaceutics Pharmacology Drug-Induced Hepatotoxicity and ProtectionHealth Sciences Medicine Hepatology Liver Diseases and ImmunityHealth Sciences Medicine Hepatology Hepatitis C virus researchBACKGROUND & 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.Articlehttps://pubmed.ncbi.nlm.nih.gov/37269163https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/liv.15623https://doi.org/10.1111/liv.1562310.1111/liv.15623https://hdl.handle.net/20.500.15037/1070W4379197429enLiver International1478-32231478-32312023-06-032026-06-13T09:45:20Z2026-06-13T09:45:20Z |
| spellingShingle | Autoimmune hepatitis Medicine Internal medicine Eosinophilia Prospective cohort study Autoimmunity Immunology Gastroenterology Hepatitis Disease Autoimmune hepatitis Medicine Internal medicine Eosinophilia Prospective cohort study Autoimmunity Immunology Gastroenterology Hepatitis Disease Transaminases Transaminases Transaminases Transaminases Bilirubin Bilirubin Bilirubin Bilirubin Female Female Female Female Humans Humans Humans Humans Prospective Studies Prospective Studies Prospective Studies Prospective Studies Registries Registries Registries Registries Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Life Sciences Pharmacology, Toxicology and Pharmaceutics Pharmacology Drug-Induced Hepatotoxicity and Protection Health Sciences Medicine Hepatology Liver Diseases and Immunity Health Sciences Medicine Hepatology Hepatitis C virus research Miren García‐Cortés Aida Ortega‐Alonso Gonzalo Matilla‐Cabello Inmaculada Medina‐Cáliz Agustín Castiella Isabel Conde Elvira Bonilla‐Toyos José M. Pinazo-Bandera Nelia Hernández Martín Tagle Vinícius Nunes Raymundo Paraná Fernando Bessone Neil Kaplowitz M. Isabel Lucena Ismael Álvarez‐Álvarez Mercedes Robles‐Díaz Raúl J. Andrade Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries |
| title | Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries |
| title_full | Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries |
| title_fullStr | Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries |
| title_full_unstemmed | Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries |
| title_short | Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries |
| title_sort | clinical presentation causative drugs and outcome of patients with autoimmune features in two prospective dili registries |
| topic | Autoimmune hepatitis Medicine Internal medicine Eosinophilia Prospective cohort study Autoimmunity Immunology Gastroenterology Hepatitis Disease Autoimmune hepatitis Medicine Internal medicine Eosinophilia Prospective cohort study Autoimmunity Immunology Gastroenterology Hepatitis Disease Transaminases Transaminases Transaminases Transaminases Bilirubin Bilirubin Bilirubin Bilirubin Female Female Female Female Humans Humans Humans Humans Prospective Studies Prospective Studies Prospective Studies Prospective Studies Registries Registries Registries Registries Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Life Sciences Pharmacology, Toxicology and Pharmaceutics Pharmacology Drug-Induced Hepatotoxicity and Protection Health Sciences Medicine Hepatology Liver Diseases and Immunity Health Sciences Medicine Hepatology Hepatitis C virus research |
| topic_facet | Autoimmune hepatitis Medicine Internal medicine Eosinophilia Prospective cohort study Autoimmunity Immunology Gastroenterology Hepatitis Disease Autoimmune hepatitis Medicine Internal medicine Eosinophilia Prospective cohort study Autoimmunity Immunology Gastroenterology Hepatitis Disease Transaminases Transaminases Transaminases Transaminases Bilirubin Bilirubin Bilirubin Bilirubin Female Female Female Female Humans Humans Humans Humans Prospective Studies Prospective Studies Prospective Studies Prospective Studies Registries Registries Registries Registries Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune drug therapy Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Hepatitis, Autoimmune epidemiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury etiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Chemical and Drug Induced Liver Injury epidemiology Life Sciences Pharmacology, Toxicology and Pharmaceutics Pharmacology Drug-Induced Hepatotoxicity and Protection Health Sciences Medicine Hepatology Liver Diseases and Immunity Health Sciences Medicine Hepatology Hepatitis C virus research |
| url | https://pubmed.ncbi.nlm.nih.gov/37269163 https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/liv.15623 https://doi.org/10.1111/liv.15623 https://hdl.handle.net/20.500.15037/1070 |
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