{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:22:46Z","timestamp":1780050166729,"version":"3.53.1"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Pulse steroid therapy occasionally causes drug\u2010induced autoimmune\u2010like hepatitis (DI\u2010ALH), but the long\u2010term outcome of treated patients is not well known. In this study, we investigated the long\u2010term outcomes of DI\u2010ALH due to pulse steroid therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the medical records of 405 patients treated with pulse high\u2010dose methylprednisolone in Kurashiki Central Hospital. The frequency and clinicopathological characteristics of acute liver injury that occurred within 3\u00a0months after the therapy were analyzed. The diagnosis of DI\u2010ALH was made according to the revised international autoimmune hepatitis group criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 405 patients treated with methylprednisolone, 61 (15.1%) had acute liver injury after the pulse steroid therapy, and DI\u2010ALH was diagnosed in five patients (1.2%). Absence of oral prednisolone tapering after the pulse steroid therapy was a significant risk factor for the subsequent development of DI\u2010ALH (odds ratio 11.9; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.017). One patient was treated with 3\u00a0days of intravenous methylprednisolone followed by oral prednisolone. Two patients were treated with glycyrrhizin followed by oral prednisolone due to ineffectiveness of glycyrrhizin. Remission was achieved with glycyrrhizin alone, and spontaneous remission without drug therapy occurred in one patient each. During the median follow\u2010up period of 34\u00a0months, no relapse was evident in all the patients without maintenance therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pulse steroid therapy can cause DI\u2010ALH, especially when subsequent prednisolone is not tapered. Prednisolone is effective for DI\u2010ALH due to pulse steroid therapy, and can be safely withdrawn once remission is achieved.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13940","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T21:15:51Z","timestamp":1687641351000},"page":"1073-1083","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Long\u2010term outcomes of drug\u2010induced autoimmune\u2010like hepatitis after pulse steroid therapy"],"prefix":"10.1111","volume":"53","author":[{"given":"Masayuki","family":"Ueno","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kurashiki Central Hospital  Kurashiki Japan"},{"name":"Department of Gastroenterology and Hepatology Graduate School of Medicine Kyoto University  Kyoto 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