Clinical and histological features of idiosyncratic liver injury: Dilemma in diagnosis of autoimmune hepatitis

• Published in: Hepatology research 2016-04, Vol.46 (4), p.277-291
• Main Authors: Kuzu, Ufuk Bariş, Öztaş, Erkin, Turhan, Nesrin, Saygili, Fatih, Suna, Nuretdin, Yildiz, Hakan, Kaplan, Mustafa, Akpinar, Muhammet Yener, Akdoğan, Meral, Kaçar, Sabite, Kiliç, Zeki Mesut Yalin, Köksal, Aydin Şeref, Ödemiş, Bülent, Kayaçetin, Ertuğrul
• Format: Article
• Language: English
• Subjects: autoimmune hepatitis; clinical and histological features; drug-induced liver injury
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/hepr.12530

Aim Drug‐induced liver injury (DILI) is becoming a worldwide problem with its still unexplained properties. Methods The data of patients who were diagnosed with DILI between January 2008 and December 2013 were assessed. Results Five patients had been diagnosed with intrinsic and 82 patients with idiosyncratic DILI. The most common causative agents were antimicrobial drugs. The most common injury pattern was hepatocellular. When patients with bilirubin levels of more than 5 mg/dL were divided into two groups according to receiving steroid therapy (n = 11) or not (n = 40), there was not any significant difference according to their clinical results (P > 0.05). Five of the idiosyncratic DILI patients were diagnosed with drug‐induced autoimmune hepatitis (DI‐AIH). In histopathological examination, hepatic rosette formation and emperipolesis were observed to be more common among patients with DI‐AIH when compared with ones without (P