Seid Amir Sultan, Adeyi Oyedele, Thomson Mary
Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN.
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
ACG Case Rep J. 2025 Aug 1;12(8):e01777. doi: 10.14309/crj.0000000000001777. eCollection 2025 Aug.
Drug-induced autoimmune-like hepatitis represents a distinct phenotype of drug-induced liver injury characterized by clinical, biochemical, and/or histological features resembling autoimmune hepatitis. We present a case of severe Isoniazid (INH) -induced drug-induced autoimmune-like hepatitis in a 62-year-old man with a dramatic response to corticosteroid therapy after INH discontinuation alone proved insufficient. Initial laboratory tests showed markedly elevated transaminases and profound hyperbilirubinemia. Despite INH discontinuation, his clinical condition did not improve. Liver biopsy revealed severe acute hepatitis with interface hepatitis, lymphoplasmacytic infiltration, and multiple foci of lobular confluent necrosis. Prednisone therapy led to rapid clinical improvement and normalization of liver biochemistries over 3 months.
药物性自身免疫样肝炎是药物性肝损伤的一种独特表型，其临床、生化和/或组织学特征类似于自身免疫性肝炎。我们报告一例62岁男性因异烟肼（INH）导致的严重药物性自身免疫样肝炎病例，在单独停用INH证明不足后，对皮质类固醇治疗有显著反应。初始实验室检查显示转氨酶显著升高和严重高胆红素血症。尽管停用了INH，他的临床状况并未改善。肝活检显示严重急性肝炎伴界面性肝炎、淋巴细胞浆细胞浸润和多个小叶融合性坏死灶。泼尼松治疗导致临床迅速改善，肝脏生化指标在3个月内恢复正常。
