Aldenhoven Mieke, van Enk J Gert, Avis Wim A
Ziekenhuis Gelderse Vallei, afd. Kindergeneeskunde, Ede, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(3):A5465.
Drug-induced autoimmune hepatitis is an acute and potentially severe side effect, particularly often reported after the long-term use of minocycline. The condition's characteristic biochemical findings are highly elevated transaminase levels, only mildly increased markers of cholestasis and bilirubin levels, an elevated IgG concentration and a high antinuclear antibody (ANA) titre.
A 14-year-old girl developed autoimmune hepatitis due to the long-term use of minocycline for acne vulgaris. She presented with icterus and very high transaminase levels. The patient made a full recovery after the medication was discontinued.
This type of autoimmune hepatitis can be differentiated from 'classic' autoimmune hepatitis by the patient's quick recovery after stopping the inducing drug and no relapse of the condition after the discontinuation of glucocorticoid therapy.
药物性自身免疫性肝炎是一种急性且可能严重的副作用,长期使用米诺环素后尤其常被报道。该病症的特征性生化检查结果为转氨酶水平大幅升高、胆汁淤积标志物和胆红素水平仅轻度升高、免疫球蛋白G浓度升高以及抗核抗体(ANA)滴度升高。
一名14岁女孩因长期使用米诺环素治疗寻常痤疮而患上自身免疫性肝炎。她出现黄疸和极高的转氨酶水平。停药后患者完全康复。
这种类型的自身免疫性肝炎可通过患者在停用诱发药物后迅速康复且停用糖皮质激素治疗后病情无复发,与“经典”自身免疫性肝炎相鉴别。