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. 2019 Mar 24;7(6):825–837. doi: 10.1177/2050640619840147

Table 2.

Summarized biochemical, liver injury pattern and autoimmunity information of methylprednisolone-induced liver injury events at peak reviewed from literature (n = 50) and new reported cases (n = 3).

Author Case TBL (mg/dL) AST (U/L) ALT (U/L) ALP (U/L) Type of injury Autoantibodies; meeting nHy's law criteria
Davidov et al. 1 6.3 N/A 2287 123 HC ASMA+; nHy
Moleti et al. (1) 2 N/A 486 809 N/A N/A -
Moleti et al. (2) 3 N/A 338 903 N/A N/A ANA + (low titers)
Grilli et al. 4 24 1104 2000 114 HC nHy
Ferraro et al. (1) 5 N/A 136 355 N/A N/A -
Ferraro et al. (2) 6 N/A 157 627 N/A N/A -
Ferraro et al. (3) 7 N/A 109 260 N/A HCa ANA + (1:640); ASMA + (1:80)
Ferraro et al. (4) 8 N/A 315 671 N/A HCa -
Oliveira et al. 9 16 710 2308 92 HC ANA + (1:40), nHy
Melamud et al. 10 3.4 283 465 80 HC nHy
D'Agnolo et al. 11 1.7 2384 3028 N/A HCa -
Carrier et al. 12 N/A 3315 3768 N/A HCa ANA + (1:160); nHyd
Alva et al. 13 3.3 1428 2618 134 HC nHy
Furutama et al. 14 0.8 278 428 N/A N/A ANA + (1:80)
Gutkowski et al. 15 18 900 1740 186 HC ASMA + (>1:320); nHy
Loraschi et al. (1) 16 N/A 349 1042 N/A HCa -
Loraschi et al. (2) 17 N/A 39 122 N/A N/A -
Maámouri et al. 18 1 229 553 228 HC ANA + (1:100); ASMA + (1:100)
Rivero et al. 19 N/A 1328 2685 115 HC -
Takahashi et al. 20 3.4 1102 1067 377 HC ANA + (1:80); ASMA+; nHy
Reuß et al. 21 N/A 485 1082 N/A HCa N/A
Topal et al. 22 10 1600 2478 138 HC nHy
Das et al. 23 N/A 1500 1600 200 HC nHyd
Hofstee et al. 24 N/A 755 1095 140 HC -
Marinó et al. 25 N/A 990 1419 N/A HCa -
Marinó et al. (1) 26 N/A 2280 2490 498 HC ANA + (low titers); nHyd
Marinó et al. (2) 27 N/A 68 179 100 HC N/A
Marinó et al (3) 28 N/A N/A N/A N/A N/A N/A
Marinó et al. (4) 29 N/A 888 1971 178 HC N/A
Marinó et al. (5) 30 N/A 457 930 237 HC anti-LKM-1
Marinó et al. (6) 31 N/A 635 1044 245 HC -
Marinó et al. (7) 32 N/A 948 1815 183 HC -
Salvi et al. 33 N/A 634 1152 N/A HCa ANA + (high titers)
Weissel et al. 34 N/A N/A N/A N/A HCa N/A
Dumontier et al. (1) 35 N/A 29b 34b N/A HCc -
Dumontier et al. (2) 36 N/A 14b 33b N/A HCc -
Dumontier et al. (3) 37 N/A 5.3b 9.6b N/A HCc -
Dumontier et al. (4) 38 N/A N/A 50b N/A HCc -
Dumontier et al. (5) 39 3.7 2235 1704 N/A HCc nHy
Hidalgo et al. (1) 40 N/A N/A N/A N/A HCa nHyd
Hidalgo et al. (2) 41 N/A N/A N/A N/A N/A -
Hidalgo et al (3) 42 N/A N/A N/A N/A N/A -
Abramavicius et al. 43 N/A 89 194 N/A N/A AMA + (1/40); ANA + (1/40)
Lee et al. 44 1.6 660 1242 N/A HCa -
Kadle et al. 45 N/A 1774 1047 175 HC ANA + (1/160); nHyd
Adamec et al. (1) 46 N/A 1095 2259 N/A HCa -
Adamec et al. (2) 47 N/A 74 395 N/A N/A ASMA + (1/160)
Adamec et al. (3) 48 N/A N/A 1340 N/A HCa nHyd
Bresteau et al. (1) 49 2.9 778 1512 86 HC ANA + (1/80); nHy
Rotondo et al. 50 2.1 1142 2438 N/A HCa nHy
Our cases
Patient 1 3.6 1420 2194 229 HC ANA + (1/320), nHy
Patient 2 1.30 771 1459 106 HC -
Patient 3 13.9 1823 2737 169 HC nHy
Mean U/L (range) e 6.5 mg/dL (0.8–24) 907 (39–3315) 1443 (122–3768) 180 (80–498)
a

When ALT values and/or pathological findings were suggestive of hepatic cytolytic features, but ALP values were not available.

b

Normalized values provided by author and rough parameters not available in U/L.

c

Ratio provided by author.

d

When TBL values were not available, but patient had presented jaundice.

e

Mean was calculated based on reports which included AST, ALT and ALP in U/L.

Abbreviations: TBL: serum total bilirubin; AST: aspartate aminotransferase; ALT: alanine aminotransferase; ALP: alkaline phosphatase; ANA: antinuclear antibody titres; ASMA: anti-smooth muscle antibody titres; anti-LKM-1: anti-liver/kidney microsomal antibody type 1; AMA: antimitochondrial antibody; N/A: not available; nHy: new Hy's law criteria were applied, where nR>5+TBL>2xULN, and nR was calculated as (ALT or AST (whichever was highest)/ULN)/(ALP/ULN); ULN: upper limit of normal.