{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:27:31Z","timestamp":1790108851814,"version":"4.0.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Idiosyncratic hepatotoxicity is a type of drug-induced liver injury (DILI) that is unpredictable and clinically severe, and amoxicillin clavulanate (AC) is the most implicated drug in DILI worldwide. The clinical manifestations of amoxicillin clavulanate-induced liver injury (AC-DILI) are fatigue and jaundice, which some allergic features may accompany, but autoimmune phenomena are uncommon. Here, we describe a special case report of a patient with AC-DILI accompanied by autoimmune phenomena for the first time. The patient was a middle-aged Chinese woman who developed liver damage after taking AC for a period of time, with a RUCAM score of 6. The patient tested positive for antinuclear antibodies and had elevated levels of IgG. Human leukocyte antigen (HLA)-targeted sequencing results showed that the patient did not carry known AC-DILI-related HLA polymorphisms, but Sanger sequencing suggested that the patient had the ERAP2 rs1363907 mutation, which may be a pathogenic factor of AC-DILI in the patient. The patient\u2019s progress notes, disease diagnosis, and treatment are summarized, and the role of ERAP2 pathogenic mutation rs1363907 in AC-DILI is discussed.<\/jats:p>","DOI":"10.3389\/fphar.2025.1564124","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T04:10:33Z","timestamp":1747800633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The role of endoplasmic reticulum aminopeptidase ERAP2 pathogenic mutation rs1363907 in amoxicillin clavulanate-induced liver injury: a special case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Yan","family":"Zhan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Mao","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Ye","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"277","DOI":"10.2165\/00002018-200730040-00001","article-title":"Drug-induced liver injury","volume":"30","author":"Abboud","year":"2007","journal-title":"Drug Saf."},{"key":"B2","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1055\/s-0035-1567829","article-title":"Genome-wide association studies in drug-induced liver injury: step change in understanding the pathogenesis","volume":"35","author":"Aithal","year":"2015","journal-title":"Semin. 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