Table 1.
Review of clinical characteristics of reported cases of GA associated liver injury.
| Case | Sex | Age (years) | Onset (days) | Symptoms | AST | ALT | AP | Bi | Ultrasound | Viral serologies (negative) |
Autoimmunity markers* | Biopsy | Recovery (days) | Diagnosis |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Neumann et al. (2007) | M | 71 | 60 | Jaundice, malaise | 178 | 317 | 138 | 7.6 | Normal | HV, HEV, EBV, CMV, VZV, HSV | ANA (+) 1:1280 | DILI | 30 | AIH |
| Von Kalckreuth et al. (2008) | F | 42 | 60 | 14.7 | ANA (+) SMA (+) |
Lymphocytic inflammation | IS | AIH | ||||||
| Deltrene et al. (2009) | F | 52 | 90 | No | 320 | 140 | Normal | Normal | Normal | HV, EBV, CMV | ANA (+) 1:320 SMA (+) 1:80 |
DILI | 90 | DILI |
| Subramaniam et al. (2012) | F | 31 | 37 | Jaundice, anorexia, lethargy | 276 | 1056 | 143 | 6.4 | Increased echogenicity | HV, EBV, CMV | SMA (+) 1:320 | DILI | 60 | DILI |
| Makhani et al. (2013) | F | 15 | 60 | Fatigue | 500 | 1150 | Normal | Fatty infiltration | HV, EBV | Negative (not AMA) |
DILI | 54 | DILI | |
| Onmez et al. (2013) | F | 36 | 90 | Fatigue, jaundice, nausea | 1834 | 1475 | 231 | 24.4 | Normal | HV, EBV, CMV | Negative | DILI | 36 | DILI |
| Sinagra et al. (2013) | F | 41 | 30 | 1612 | 4410 | 383 | 5 | HV (not A), EBV, CMV, HIV | ANA (+) 1:320 | Inflammation, eosinophilic infiltrate, fibrosis | 30 | AIH | ||
| Sinagra et al. (2013) | F | 29 | 30 | Jaundice, asthenia | 820 | 1260 | 342 | 4 | HV, EBV, CMV, HIV | ANA (+) 1:160 | Lymphocitic infiltrate, fibrosis | IS | AIH | |
| Antezana et al. (2014) | F | 28 | 180 | Jaundice | 905 | 1103 | 8 | HV | Negative | DILI | 30 | DILI | ||
| La Gioia et al. (2014) | F | 25 | 240 | Anorexia, constipation | 641 | 1433 | Normal | 1.5 | Reactive lymph nodes | HV, EBV, CMV | Negative | DILI | 56 | DILI |
| Fernández et al. (2015) | F | 42 | 180 | No | 383 | 602 | 2.2 | Normal | HV, HEV, EBV,CMV,HSV | ANA (+) 1:640 | DILI | 30 | DILI | |
| Almeida et al. (2016) | F | 65 | 7 | Petechiae | 448 | 667 | 151 | Normal | Simple cysts | HV, HDV, EBV, CMV | ANA (+) 1:40 SMA (+) 1:40 |
No | 147 | DILI |
AIH, autoimmune hepatitis; ALT, alanine aminotransferase (U/liter); AP, alkaline phosphatase (U/liter); AST, aspartate aminotransferase (U/liter); Bi, bilirubin (mg/dl); CMV, cytomegalovirus; DILI, drug-induced liver injury; EBV, Epstein–Barr virus; GA, glatiramer acetate; HDV, hepatitis D virus; HEV, hepatitis E virus; HIV, human immunodeficiency virus; HSV, herpes simplex virus; HV, hepatotropic virus (includes A, B and C viruses; others are specified if tested); IS, immunosuppressive treatment; VZV, Varicella Zoster virus.
Includes antinuclear antibodies (ANAs), smooth muscle antibodies (SMAs), liver kidney microsome antibodies and antimitochondrial antibodies (AMAs), except for Makhani et al. (2013), who did not include AMAs. Von Kalckreuth et al. (2008) and Antezana et al. (2014) studies do not specify more antibodies than those written. In Deltrene et al. (2009) and Subramaniam et al. (2012) studies, antibodies turned negative during follow up.