Table 1.
Summary of case series of patients with DI-ALH and response to treatment.
| Observational studies | Björnsson 201014 | Ghabril 201335 | Rodrig. | De Boer 201724 | Björnsson | Björnsson | García-Cortés |
|---|---|---|---|---|---|---|---|
| (n = 24) | (n = 6) | 201534 (n = 8) | (n = 88) | 201717 (n = 15) | 202250 (n = 36) | 202351 (n = 33) | |
| Drugs implicated (number of patients) | Nitrourantoin (10) Minocycline (10) Cephalexin (1) Prometrium (1) |
Infliximab (3) Etanercept(2) Adalimumab |
Infliximab (7) Adalimumab |
Nitrofurantoin (42) Minocycline (28) Methyldopa (10) Hydralazine (7) |
Infliximab (10) Nitrofurantoin (3) Imatinib |
Infliximab (31) | Statins (8) Nitrofurantoin (5) Minocycline (4) Amox-Clav (2) Cyproterone (2) Others (11) |
| Age (years), median (range) | 53 (24–61)¥ | 35 (28–54) | 40 (34–69) | Nitrofurantoin 65 (36–84) Minocycline 19 (16–61) Methyldopa 29 (18–43) Hydralazine 60 (42–76) |
55 (20–91) | 46 (32–54)¥ | Mean 53 (15–86) |
| Females % | 92% | 83% | 63% | 91% | 93% | 78% | 58% |
| Autoimmune comorbidities, % | — | 100% | 100% | — | 73% | — | 27% |
| Acute onset, % | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Treatment duration (days), median (range) | — | — | — | — | 116 (84–1,320) | — | 92 (40–312)¥ |
| Time to onset (days), median (range) | — | 112 (14–364) | — | 277 (8–7,032) 100 (13–1572)* |
— | 110 (94–144)¥ | 94 (42–255)¥ |
| Jaundice, % | 50% | 50% | — | 59% | 53% | 11% | 58% |
| Type of liver injury, % | — | HC: 83% Mix: 17% Chol: 0% |
— | HC: 74% Mix: 17% Chol: 9% |
HC: 93% Mix: 7% Chol: 0% |
HC: 64% Mix: 33% Chol: 3% |
HC: 84% Mix: 9.7% Chol: 6.3% |
| Hypersensivity features, % | — | Fever: 16% | — | Fever: 25% Rash: 26%. At least two features: 17% |
— | No fever, no rash | Fever: 6% Rash: 3% |
| % with peripheral eosinophilia | — | 0% | — | 4.5% | — | 8% | 18% |
| % with autoimmune features | 100% | 50% | 100% | 72% | 93% | 69% | 100% |
| High IgG values, % | 90% | — | 75% | 39% | 40% | 17% | 58%† |
| Corticosteroids: dose/duration | 20–40 mg × 8 weeks | — | — | — | 20–40 mg × 8 weeks | 20–40 mg × 8 weeks | — |
| Response to suspension of drug and | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| steroids (number) | Spontaneous (14) | Spontaneous (1) | Steroids (8) | Spontaneous (47) | Spontaneous (6) | Spontaneous (19) | Spontaneous (13) |
| Steroids (12) | Steroids (5) | Steroids (41) | Steroids (9) | Steroids (17) | Steroids (20) | ||
| Relapse after corticosteroid withdrawal | 0% | 0% | 0% | — | 0% | 0% | 12% |
| Cirrhosis at presentation | 0% | 16% | 13% | 4.5%, at follow-up | 0% | — | 6% |
AIH, autoimmune hepatitis. Amox/Clav, amoxicillin/clavulanate; Chol, cholestatic; HC, hepatocellular; Mix, mixed.
*
Patients with and without autoimmune features, respectively.
†
Based on available data.
¥
Interquartile range (IQR).