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Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries

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dc.contributor.author García-Cortés, Miren
dc.contributor.author Ortega-Alonso, Aida
dc.contributor.author Matilla-Cabello, Gonzalo
dc.contributor.author Medina-Cáliz, Inmaculada
dc.contributor.author Castiella, Agustín
dc.contributor.author Conde, Isabel
dc.contributor.author Bonilla-Toyos, Elvira
dc.contributor.author Pinazo-Bandera, José
dc.contributor.author Hernández, Nelia
dc.contributor.author Tagle Arróspide, Francisco Martin
dc.contributor.author Nunes, Vinicius
dc.contributor.author Parana, Raymundo
dc.contributor.author Bessone, Fernando
dc.contributor.author Kaplowitz, Neil
dc.contributor.author Lucena, M. Isabel
dc.contributor.author Alvarez-Alvarez, Ismael
dc.contributor.author Robles-Díaz, Mercedes
dc.contributor.author Andrade, Raúl J.
dc.date.accessioned 2023-10-09T17:09:16Z
dc.date.available 2023-10-09T17:09:16Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14210
dc.description.abstract 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. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Liver International
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Autoimmune features en_US
dc.subject Autoimmune hepatitis en_US
dc.subject Drug-induced autoimmune-like hepatitis en_US
dc.subject Drug-induced liver injury en_US
dc.subject Hepatotoxicity en_US
dc.title Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1111/liv.15623
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.05
dc.relation.issn 1478-3231


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