Drug-induced autoimmune hepatitis


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Аннотация

Drug-induced autoimmune hepatitis (DIAIH) is an infrequent but serious complication of pharmacotherapy. It is one of the most severe variants of drug-induced liver damage with a potentially unfavorable prognosis in the natural course. However, if diagnosis and treatment are made in time, the symptoms of this disease completely disappear without relapse and cirrhosis is not formed. At the same time, there are certain difficulties in the diagnosis of DI AIH by practical health professionals due to the low level of awareness about this disease. The purpose of this research is to analyze and systematize data on drugs and on the pathophysiological mechanisms which can potentially lead to the development of DI AIH. Currently, the prevalence of the disease remains unknown, what is largely caused due to the individual reaction to the particular drug. Two types of factors may be important in the development of DI AIH. Those, which are directly related to the features of MP biotransformation in the body and those, which are associated with the individual profile. There are no pathognomonic diagnostic criteria for DIAIH, however, based on its similarity to idiopathic AIH, the most important criteria are: time of symptoms manifestation, rash, arthralgias and/or extrahepatic manifestations, hepatocellular character of increased serum enzyme levels, the presence of autoantibodies, increased levels of immunoglobulins, treatment with drugs that are associated with the DIAIH development, characteristic features of chronic hepatitis in a liver biopsy, rapid response to corticosteroid therapy and the disappearance of symptoms after discontinuation of drugs. The main thing in the treatment of AIH, as well as any DI, is the cancellation of the inducer drug. In some cases, this measure can lead to the disappearance of clinical symptoms and reduction of pathological changes in liver enzymes in the biochemical analysis of blood without additional corticosteroid therapy. In other cases, DIAIH requires prednisone therapy. If there is no effect from glucocorticoids, mofetil mycophenolate, calcineurin inhibitors (cyclosporine and tacrolimus) are considered as reserve drugs.

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Авторлар туралы

O. Ostroumova

Russian Medical Academy of Continuous Professional Education

Email: ostroumova.olga@mail.ru
Moscow, Russia

A. Filippova

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

A. Kochetkov

Russian Medical Academy of Continuous Professional Education

Moscow, Russia

Әдебиет тізімі

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