Autoimmune Hepatitis: A Devious Path Towards Diagnosis
DOI:
https://doi.org/10.60591/crspmi.86Keywords:
Albendazole/adverse effects, Chemical and Drug Induced Liver Injury, Hepatitis, Autoimmune/etiologyAbstract
Acute hepatitis is a life-threatening condition that can lead to liver transplant. Rapid risk stratification and identification of the etiologic agent is essential in addressing these cases.
In the pursuit of an etiological agent of acute hepatitis, it is necessary to first exclude viral and toxic agents since diagnosis of autoimmune origin is considered a diagnosis of exclusion.
We present the case of a young woman, without any relevant preexisting history, diagnosed with acute autoimmune hepatitis (AIH), having been initially suspected of a drug-induced liver injury (DILI) due to albendazole intake. The patient was hospitalized for an extended period and was at risk of undergoing a liver transplant. It is our intent to reveal the diagnostic process of this case and the difficulties that were overcome, as well as open up discussion to the topic of drug-induced autoimmune hepatitis (DIAIH).
Downloads
References
Friedman LS. Approach to the patient with abnormal liver biochemical and function tests. 2022 Abr 5 [citado em 2022 Maio 17]. In: UptoDate [Internet]. Disponível em: https://www.uptodate.com/contents/approach-to-the-patient-with-abnormal-liver-biochemical-and-function-tests;
Goldberg E, Chopra S, Rubin JN. Acute liver failure in adults: Etiology, clinical manifestations, and diagnosis. 2022 Maio 12 [citado em 2022 Maio 17]. In: UptoDate [Internet]. Disponível em: https://www.uptodate.com/contents/acute-liver-failure-in-adults-etiology-clinical-manifestations-and-diagnosis;
Heneghan MA. Overview of autoimmune hepatitis. 2022 Abr 4 [citado em 2022 Maio 17]. In: UptoDate [Internet]. Disponível em: https://www.uptodate.com/contents/overview-of-autoimmune-hepatitis;
Castiella A, Zapata E, Lucena MI, Andrade RJ. Drug-induced autoimmune liver disease: A diagnostic dilemma of an increasingly reported disease. World J Hepatol. 2014;6:160-8. doi: 10.4254/wjh.v6.i4.160.
EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol. 2015;63:1543-4; doi: 10.1016/j.jhep.2015.06.030
Heneghan MA. Autoimmune hepatitis: Treatment. 2022 May 13 [citado em 2022 Maio 17]. In: UptoDate [Internet]. Disponível em: https://www.uptodate.com/contents/autoimmune-hepatitis-treatment;
Fontana RJ, Liou I, Reuben A, Suzuki A, Fiel MI, Lee W, Navarro V. AASLD practice guidance on drug, herbal, and dietary supplement-induced liver injury. Hepatology. 2023;77:1036-5. doi: 10.1002/hep.32689.
Larson AM. Drugs and the liver: Metabolism and mechanisms of injury. 2021 Jun 07 [citado em 2023 Janeiro 7]. In: UptoDate [Internet]. Disponível em: https://www.uptodate.com/contents/drugs-and-the-liver-metabolism-and-mechanisms-of-injury;
European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu; Clinical Practice Guideline Panel: Chair:; Panel members; EASL Governing Board representative:EASL Clinical Practice Guidelines: Drug-induced liver injury. J Hepatol. 2019;70:1222-61. doi: 10.1016/j.jhep.2019.02.014.
Björnsson E, Talwalkar J, Treeprasertsuk S, Kamath PS, Takahashi N, Sanderson S, et al. Drug-induced autoimmune hepatitis: clinical characteristics and prognosis. Hepatology. 2010;51:2040-8. doi: 10.1002/hep.23588.
Lexicomp. Albendazole: Drug information. [citado em 2022 Maio 17]. In: UptoDate [Internet]. Disponível em: https://www.uptodate.com/contents/albendazole-drug-information;
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2020 Jul 1. [citado em 2023 Jan 7]. Bethesda: National Institute of Diabetes and Digestive and Kidney Diseases; 2012. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK547852/
Koca T, Akcam M. Albendazole-induced autoimmune hepatitis. Indian Pediatr. 2015;52:78-9.
