Nishikawa Hiroki, Kim Soo Ki, Asai Akira
Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan.
Department of Gastroenterology, Kobe Asahi Hospital, Kobe 653-8501, Hyogo, Japan.
J Clin Med. 2025 Jun 25;14(13):4514. doi: 10.3390/jcm14134514.
Autoimmune hepatitis (AIH) is the most common liver disease caused by autoimmunity. In Japan, the number of patients with AIH has been increasing in recent years. AIH develops as a result of the loss of immune tolerance to autoantigens in the liver. Drug-induced liver injury (DILI) is an extremely important cause of liver injury in clinical practice and should always be kept in mind in the differential diagnosis. Recently, DILI caused by immune checkpoint inhibitors has been attracting attention. For the diagnosis of DILI, it is important to carefully exclude other possible causes of liver injury and obtain a detailed history of medications and the timing of their use. On the other hand, drug-induced AIH, like hepatitis, also exists and is clinically important because it is often difficult to differentiate from idiopathic AIH. A solid understanding of the pathogenesis of both AIH and DILI is essential for clinicians. This article provides an overview of AIH and DILI in Japan, including the latest findings.
自身免疫性肝炎（AIH）是由自身免疫引起的最常见肝脏疾病。在日本，近年来AIH患者数量一直在增加。AIH是由于肝脏对自身抗原的免疫耐受性丧失而发展起来的。药物性肝损伤（DILI）是临床实践中肝损伤的一个极其重要的原因，在鉴别诊断中应始终牢记。最近，免疫检查点抑制剂引起的DILI受到了关注。对于DILI的诊断，仔细排除其他可能的肝损伤原因并获取详细的用药史及其使用时间非常重要。另一方面，药物性AIH也存在，并且在临床上很重要，因为它通常难以与特发性AIH区分开来。临床医生必须对AIH和DILI的发病机制有扎实的了解。本文概述了日本的AIH和DILI，包括最新研究结果。
