Natural history and outcomes in drug induced autoimmune hepatitis

Yeong, Tian T, Lim, Kok H J, Goubet, Stephanie, Parnell, Nick and Verma, Sumita (2016) Natural history and outcomes in drug induced autoimmune hepatitis. Hepatology Research, 46 (3). E79-E88. ISSN 1386-6346

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Abstract

Aim: Drug-induced autoimmune hepatitis (DIAIH) remains poorly characterized. Our aim was to assess natural history and outcomes in DIAIH.

Methods: This was a retrospective cohort study.

Results: Eighty-two patients with autoimmune hepatitis (AIH) were identified, 11 (13.4%) with DIAIH, implicated drugs being nitrofurantoin (n = 4), statins (n = 4), herbal remedies (n = 2) and diclofenac (n = 1). Female sex, acute onset, elevated serum globulins/immunoglobulin G, fibrosis stage (Ishak), cirrhosis at onset, moderate–severe portal inflammation, interface and lobular hepatitis, remission, relapse and poor outcome were similar in those with DIAIH and AIH (P > 0.05). The former were however more likely to be aged 60 years or more and take longer to relapse on immunosuppression discontinuation (P = <0.05). On Kaplan–Meier analysis, probability of poor outcome was similar in those with DIAIH and AIH (log–rank test, 0.339). On comparing those with (n = 4) and without nitrofurantoin (n = 7) DIAIH, the former were older, had longer duration of drug use prior to DIAIH diagnosis, higher fibrosis stage and were less likely to relapse upon immunosuppression discontinuation.

Conclusion: Approximately 15% of patients with AIH have DIAIH with similar outcomes, although the latter are older with a propensity for late relapse, mandating long-term follow up.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Subjects: R Medicine > R Medicine (General) > R852 Research. Experimentation
Depositing User: Sumita Verma
Date Deposited: 03 Jan 2017 13:18
Last Modified: 06 Mar 2017 14:35
URI: http://sro.sussex.ac.uk/id/eprint/65995

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