RT Journal Article
T1 Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries
A1 García-Cortés, Miren
A1 Ortega-Alonso, Aida
A1 Matilla-Cabello, Gonzalo
A1 Medina-Cáliz, Inmaculada
A1 Castiella, Agustin
A1 Conde, Isabel
A1 Bonilla-Toyos, Elvira
A1 Pinazo-Bandera, José M.
A1 Hernandez, Nelia
A1 Tagle, Martin
A1 Nunes, Vinicius
A1 Parana, Raymundo
A1 Bessone, Fernando
A1 Kaplowitz, Neil
A1 Lucena-González, María Isabel
A1 Álvarez-Álvarez, Ismael
A1 Robles-Díaz, María Mercedes
A1 Andrade-Bellido, Raúl Jesús
K1 Hígado - enfermedades
K1 Hepatitis
AB 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 re-ported, 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.
PB Wiley
YR 2023
FD 2023
LK https://hdl.handle.net/10630/26925
UL https://hdl.handle.net/10630/26925
LA spa
NO García-Cortés M, Ortega-Alonso A, Matilla-Cabello G, et al. Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries. Liver Int. 2023;00:1-12. doi:10.1111/liv.15623
NO Instituto de Salud Carlos III; Fondo Europeo de Desarrollo Regional— FEDER, Grant/Award Number: UMA18- FEDERJA-193, PI18/00901, PI19/00883 and PI21/01248; Consejería de Salud y Familia de la Junta de Andalucía, Grant/Award Number: P18-RT-  3364 and PI-  0310-    2018; Agencia Española del Medicamento; Sara Borrell, Grant/Award Number: CD20/00083; Rio Hortega, Grant/Award Number: CM21/00074; Garantía Juvenil, Grant/Award Number: SNGJ5Y6-09; Junta de Andalucía and European Social Fund; European Cooperation in Science and Technology; Universidad de Málaga/CBUAFunding for open access charge: Universidad de Málga / CBUA
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 20 ene 2026