{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:27:35Z","timestamp":1755221255347,"version":"3.43.0"},"reference-count":32,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Dis"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:p>Introduction: Drug-induced liver injury (DILI) is a rare but potentially serious clinical condition. One phenotype of DILI is termed drug-induced autoimmune like hepatitis (DI-ALH) that presents with laboratory and histological features indistinguishable from autoimmune hepatitis. Liver kidney microsomal antibodies (LKM-antibodies) are common in the diagnosis of AIH but were also described to be associated with halothane-induced DILI. Also, the antigens of anti-LKM-1 and anti-LKM-2 belong to the cytochrome P450 enzyme family that is involved in the metabolism of various drugs. Therefore, we aimed to study the impact of LKM-antibodies in the diagnostic work-up of suspected DILI in a large cohort of patients with liver injury in a tertiary care centre. Methods: We screened a large single centre hospital database and retrospectively identified 63,300 cases with liver injury as defined: AST or ALT &amp;gt;3 upper limit of normal (ULN) or AP or TBI &amp;gt;2 ULN. Of those, 82 cases with LKM immunofluorescence positivity (titre \u22651: 160) were identified, of which 64 patients fulfilled the inclusion criteria for this study. Results: Positive LKM immunofluorescence was associated with drug-induced autoimmune-like hepatitis (DI-ALH). Metamizole association was identified in half of the patients (n = 33, 52%). Eight patients with metamizole associated DI-ALHs required liver transplantation and 1 patient died. Conclusion: DI-ALH, especially after metamizole administration, can be a reason for a positivity in LKM immunofluorescence tests. Metamizole DI-ALH has a high liver-related mortality. <\/jats:p>","DOI":"10.1159\/000545507","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T13:19:05Z","timestamp":1743167945000},"page":"423-433","source":"Crossref","is-referenced-by-count":0,"title":["LKM Immunofluorescence Is Associated with DILI, Especially after Metamizole Intake"],"prefix":"10.1159","volume":"43","author":[{"given":"Kilian","family":"Bock","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Engel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elmar","family":"Jaeckel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiner","family":"Wedemeyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingmar","family":"Mederacke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young-Seon","family":"Mederacke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1064"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.017"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4121-6"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.04.001"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03117.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22062954"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510260438"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.84.2.551"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/gut.37.3.406"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840070626"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2174\/138955709788452676"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.04.033"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1055\/a-2150-2077"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.08.002"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.02.014"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(93)90101-6"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-021-01049-z"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1172\/JCI114660"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15262"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-016-0423-z"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.29011\/2574-7754.101354"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01782_7.x"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1002\/jcph.1512"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17113892"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1067871"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14254"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.12890\/2022_003349"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00996"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0676.2002.01718.x"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.05.043"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.12499"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i19.2308"}],"container-title":["Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545507","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T14:12:39Z","timestamp":1754662359000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000545507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":32,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,8,5]]},"published-print":{"date-parts":[[2025,8,5]]}},"URL":"https:\/\/doi.org\/10.1159\/000545507","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.28683020","asserted-by":"subject"}]},"ISSN":["0257-2753","1421-9875"],"issn-type":[{"type":"print","value":"0257-2753"},{"type":"electronic","value":"1421-9875"}],"subject":[],"published":{"date-parts":[[2025]]}}}