The base cause of autoimmune hepatitis is open but it is a circumstance that can be spark off in high risk patients by certain external factors like herb , computer virus , or prescription medications . Drug - induced autoimmune liver disease is a variant of Autoimmune Hepatitis which has not been defined in detail in the literature . A percentage of affected role with drug bring on autoimmune hepatitis can have symptoms quite similar to that of autoimmune hepatitis . There are many medications which have been known to cause autoimmune hepatitis even after end the medication which point that such medications activate dormant autoimmunity .
Three Clinical Settings of Drug-Induced Autoimmune Liver Disease
base on the drug - make autoimmune liver disease , three clinical mount have been put onward
In addition , there are occurrences of mixed features like drug - induce autoimmune hepatitis and immune - mediated drug - induced liver trauma . Sometimes positive autoantibodies are seen in drug - induce liver injury slip .
What Drugs Can trigger Autoimmune Hepatitis?
What are the drugs take in touch off AH ? Many clinical observations suggest that drug are likely triggers in some patients . There are several medications known to cause autoimmune hepatitis that tends to run even after stop the medicament pointing towards activating of autoimmunity by these medications . Nitrofurantoin , Oxyphenisatin , chlometacin , minocycline , halothane , Thorazine , and Apresoline can cause drug induced autoimmune hepatitis . It is interesting to note that drug - metabolizing enzymes of phase I and stage II are common targets of autoimmunity in idiopathic autoimmune hepatitis and viral hepatitis .
Other Drugs Involved in Liver Injury
Nowadays , more than 900 drugs , toxin , and herbal redress have been report to cause liver trauma . Recently , it has been report that at least 24 drug , in all probability more , have been associated with autoimmune chronic hepatitis mimic autoimmune hepatitis . With the emergence of novel statins , antibiotic , and other biologic agents it will not be surprising to see more drug being reported as being responsible for for drug - induced autoimmune hepatitis . Infliximab , adalimumab , etanercept , efalizumab , ipilimumab , atomoxetine , diclofenac , fenofibrate , phenprocoumon , pemoline , tielinic acid , dihydralazine , and benzarone are reported as being responsible for for novel drug - induced autoimmune hepatitis case . Elderly individuals have an increase endangerment of drug perniciousness . The jeopardy of drug - induced liver trauma goes up as one age for certain classes of drug like the one implicated in autoimmune - like hepatitis such as halothane , isoniazid , and Macrodantin ,
Risk Factors for Drug-Induced Autoimmune Hepatitis
The risk factors for drug - induced autoimmune - like hepatitis are irregular . The broker that may affect drug - taking behavior as well as host - specific genetic and metabolic commotion may affect drug handling . Socio - economic , psychological , and ethnic issue can shape the type , frequency , and duration of treatment , and certain diseases with propensities for a particular gender or old age group may skew the perception of jeopardy . The major risk factors implicated in idiosyncratic drug - get liver injury are erstwhile geezerhood , grammatical gender , dose , drug interaction , crabby - sensitization , genetic factors , and hepatic metabolic process of the compound .
Management of Drug-Induced Autoimmune Hepatitis
Generally , a short form of immunosuppressive discussion is sufficient for a patient with drug - get autoimmune hepatitis . intervention with corticosteroid has shown to cause remittal within six calendar month after start treatment in most of the typesetter’s case .
Conclusion
Oxyphenisatin , minocycline , nitrofurantoin , Thorazine , chlometacin , hydralazine , andf halothane are known to cause drug induced autoimmune hepatitis . More than 90 % of these drug - induced autoimmune hepatitis showcase were affiliate with two drugs , Macrodantin , and Minocin . The risk of exposure factors for drug - induct autoimmune - like hepatitis are unpredictable ( idiosyncratic ) . Old years , gender , dose , drug interaction , thwartwise - sensitization , genetic factor , and hepatic metabolism of the compound may be the hazard factor associated with idiosyncratic cases . These cases were easy accomplishable with corticosteroids and decline of disease is note after six months .
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