{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:49:14Z","timestamp":1792147754441,"version":"4.4.0"},"reference-count":12,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Denosumab, a receptor activator of nuclear factor-\u03baB ligand (RANKL) inhibitor, is widely used to treat osteoporosis. Its role as a trigger for autoimmune hepatitis (AIH) remains uncertain. We report a 68-year-old woman with osteoporosis and Hashimoto thyroiditis who developed jaundice and severe hepatocellular liver injury after 3 years of denosumab therapy. Alternative viral, obstructive, and metabolic causes were excluded. Liver biopsy demonstrated interface hepatitis with a lymphoplasmacytic portal infiltrate consistent with AIH, and autoimmune serologies were positive. Hemophagocytic lymphohistiocytosis was excluded, and an International AIH Score of 17 supported a diagnosis of definite AIH. Treatment with corticosteroid-based immunosuppression resulted in complete biochemical remission, and denosumab was discontinued with transition to zoledronic acid to prevent rebound bone loss. Whether this case represents drug-induced autoimmune-like hepatitis or de novo idiopathic AIH occurring in a susceptible individual cannot be determined definitively. Clinicians should maintain a low threshold for evaluating liver injury in patients receiving denosumab who develop jaundice or marked transaminase elevation.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag251","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T11:37:23Z","timestamp":1787053043000},"source":"Crossref","is-referenced-by-count":0,"title":["Autoimmune hepatitis following long-term denosumab therapy in a patient with Hashimoto thyroiditis"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2696-2259","authenticated-orcid":false,"given":"Jacob","family":"Maniattu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Eastern Virginia Medical School at Old Dominion University , Norfolk, VA 23507 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McAnto","family":"Antony","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical University of South Carolina\/AnMed Campus , Anderson, SC 29621 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin","family":"Maliakal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Eastern Virginia Medical School at Old Dominion University , Norfolk, VA 23507 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"2026101606195810600_luag251-B1","volume-title":"StatPearls","author":"Hildebrand","year":"2025"},{"issue":"Suppl. 2","key":"2026101606195810600_luag251-B2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1159\/000440747","article-title":"Role of histopathology in autoimmune hepatitis","volume":"33","author":"Tiniakos","year":"2015","journal-title":"Dig 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