{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:58:36Z","timestamp":1789397916348,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T00:00:00Z","timestamp":1701475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Drug\u2010induced autoimmune\u2010like hepatitis (DI\u2010AILH) is poorly defined and more data are required to better characterise and manage this disease entity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to evaluate the clinical characteristics, histology and long\u2010term outcomes of DI\u2010AILH compared with idiopathic autoimmune hepatitis (AIH).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study reviewed 28 DI\u2010AILH and 39 AIH patients in a single centre. The new (2022) and simplified (2008) AIH histology criteria were used to assess DI\u2010AILH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>DI\u2010AILH were more likely to present with jaundice (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) and higher bilirubin levels (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.04) than AIH. AIH patients had higher rate of immunosuppression (IS) use including second\u2010 and third\u2010line agents, though the time to reach biochemical remission were comparable. AIH patients had more advanced fibrosis than DI\u2010AILH (Ishak fibrosis score 3.5 vs. 1.9, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). DI\u2010AILH more commonly had eosinophilic aggregates (18% vs. 3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.031) and less commonly showed plasma cell aggregates (61% vs. 97%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) than AIH. The simplified AIH histology criteria identified 1 atypical histology within the DI\u2010AILH cohort, although this patient required long\u2010term IS. The new AIH histology criteria classified 23 (82%) as likely AIH and 5 (18%) as possible AIH. Two of the possible DI\u2010AILH did not require IS and one patient had successful IS withdrawal. Four DI\u2010AILH patients with fibrosis stage \u22643 had successful IS withdrawal compared with none in the AIH group. Four patients underwent liver transplantation (LT) in both cohorts with significantly shorter time to LT in DI\u2010AILH as the indication was for (sub)acute liver failure. Two DI\u2010AILH patients died within 60\u00a0days of LT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The new AIH histology criteria may be better at identifying DI\u2010AILH. Immunosuppression withdrawal in those without significant fibrosis may be considered. DI\u2010AILH is at risk of (sub)acute liver failure and early discussions with a transplant centre would be desirable.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12499","type":"journal-article","created":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T19:30:14Z","timestamp":1701545414000},"page":"66-75","source":"Crossref","is-referenced-by-count":20,"title":["Defining characteristics and long\u2010term prognosis of drug\u2010induced autoimmune\u2010like hepatitis: A retrospective cohort study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2458-2344","authenticated-orcid":false,"given":"Yooyun","family":"Chung","sequence":"first","affiliation":[{"name":"School of Immunology and Microbial Sciences Faculty of Life Sciences and Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Morrison","sequence":"additional","affiliation":[{"name":"School of Immunology and Microbial 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