Table 2.
Characteristics of the patients with severe liver injury after pulsed methylprednisolone therapy
| Case | Age | Sex | Time to peak (days) | Max bilirubin (mg/dl) | Max ALT (UI/L) | Max ALP (UI/L) | R‐ratio | Presence of autoantibodies | Concomitant medications | Histology | Rechallenge | RUCAM score | Final diagnosis |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 31 | F | 75 | 1.5 | 932 | 350 | 18 | None | Glatiramer acetate | NP | NP | 5 | Possible DILI |
| 2 | 24 | F | 105 | 1.3 | 778 | 290 | 17 | ASMA | Ibuprofen | Yes | NP | 0 | Probable autoimmune hepatitis |
| 3 | 19 | F | 35 | 1.46 | 1,491 | 91 | 22 | ANA, ASMA | None | Yes | NP | 1 | Definite autoimmune hepatits |
| 4 | 35 | F | 30 | 10.8 | 2,956 | 290 | 65 | None | None | Yes | Yes | 8 | Probable DILI with immunoallergic response |
| 5 | 59 | F | 90 | 1.87 | 838 | 117 | 19 | None | None | Yes | NP | 2 | Probable autoimmune hepatitis |
| 6 | 24 | M | 90 | 1.5 | 929 | 97 | 21 | None | None | Yes | Yes | 10 | Highly probable DILI |
ALT, alanine aminotrasferase; ALP, alkaline phosphatase; R, (ALT value/ALT ULN)/(ALP value/ALP ULN), R ratios of >5 define a hepatocellular, <2 a cholestatic and between 2 and 5 a mixed pattern of liver injury; ANA, anti‐nuclear antibodies; ASMA, anti‐smooth muscle antibodies; RUCAM, Roussel Uclaf Causality Assessment Method indicating that a drug is a possible (3–5), probable (6–8) or highly probable (>8) cause of liver injury; DILI, drug‐induced liver injury; NP, not performed.