PMID- 38374310
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240325
IS  - 2731-7099 (Electronic)
IS  - 2731-7080 (Linking)
VI  - 65
IP  - 4
DP  - 2024 Apr
TI  - [Drug-induced autoimmune-like liver injury].
PG  - 334-339
LID - 10.1007/s00108-024-01669-4 [doi]
AB  - Drug-induced liver injury (DILI) is a rare yet potentially life-threatening 
      disease. Besides intrinsic DILI, which is mainly caused by paracetamol overdosing 
      and which is dose-dependent and predictable, there is idiosyncratic DILI-an 
      unpredictable and dose-independent injury of the liver caused by certain 
      medications that only occurs in a minority of patients taking this drug. The 
      reason why some patients react with DILI towards a specific drug is still 
      unknown. However, the immune system plays a central role, which is underlined by 
      the association of certain human leukocyte antigen (HLA) polymorphisms and DILI 
      caused by specific drug classes. Due to the immunological processes that lead to 
      the liver injury in DILI, there are great overlaps regarding laboratory and 
      histological parameters between DILI and autoimmune hepatitis (AIH). 
      Differentiating DILI and AIH can therefore be challenging, especially at the time 
      of presentation. In addition, there are other immunologically mediated DILI 
      phenotypes, in particular the newly defined drug-induced autoimmune-like 
      hepatitis (DI-ALH) and liver injuries caused by checkpoint inhibitors (CPI). 
      DI-ALH is characterized by autoimmune features and good responses towards 
      corticosteroids, with the difference that DI-ALH mostly does not relapse after 
      discontinuation of corticosteroids. CPI-induced liver injury has become more 
      frequent with the rising use of those drugs and is characterized by a distinct 
      histopathological pattern with granulomatous hepatitis and infiltration dominated 
      by cytotoxic T cells. Similarly, the recently recognized liver injury following 
      vaccinations also shows an autoimmune phenotype; however, in contrast to AIH, 
      cytotoxic T cells seem to dominate the inflammatory infiltrates in the liver.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, 
      ein Teil von Springer Nature.
FAU - Weber, Sabine
AU  - Weber S
AD  - LMU Klinikum Munchen, Marchioninistr. 15, 81377, Munchen, Deutschland. 
      sabine.weber@med.uni-muenchen.de.
LA  - ger
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Arzneimittelinduzierte immunvermittelte Leberschadigung.
DEP - 20240219
PL  - Germany
TA  - Inn Med (Heidelb)
JT  - Innere Medizin (Heidelberg, Germany)
JID - 9918384885306676
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Humans
MH  - *Hepatitis, Autoimmune/diagnosis
MH  - *Chemical and Drug Induced Liver Injury/diagnosis
MH  - Histocompatibility Antigens Class I
MH  - Adrenal Cortex Hormones
OTO - NOTNLM
OT  - Autoimmunity
OT  - Drug-related side effects and adverse reactions
OT  - Hepatitis, autoimmune
OT  - Immune checkpoint inhibitors
OT  - Vaccinations
EDAT- 2024/02/20 11:51
MHDA- 2024/03/25 06:42
CRDT- 2024/02/20 00:02
PHST- 2024/01/25 00:00 [accepted]
PHST- 2024/03/25 06:42 [medline]
PHST- 2024/02/20 11:51 [pubmed]
PHST- 2024/02/20 00:02 [entrez]
AID - 10.1007/s00108-024-01669-4 [pii]
AID - 10.1007/s00108-024-01669-4 [doi]
PST - ppublish
SO  - Inn Med (Heidelb). 2024 Apr;65(4):334-339. doi: 10.1007/s00108-024-01669-4. Epub 
      2024 Feb 19.