• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.347-350
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• 2018

Drug-induced autoimmune hepatitis (DIAIH) is an increasingly recognized form of drug-induced liver injury that leads to a condition similar to idiopathic autoimmune hepatitis. A number of drugs have been associated with DIAIH, minocycline is one of the most well characterized. Minocycline is a semisynthetic tetracycline antibiotic used in the treatment of acne vulgaris. Minocycline-induced autoimmune hepatitis presents with serologic and histologic features similar to idiopathic autoimmune hepatitis. However, the natural history and outcomes of these two conditions differ significantly. The majority of patients with minocycline-induced autoimmune hepatitis experience complete resolution of symptoms after withdrawal of the medication. Some patients may require a short course of steroids and rarely use of an immunomodulator to achieve resolution of disease. Recurrence of symptoms is rare and typically only occurs with reintroduction of minocycline. It is important for primary care providers to consider minocycline-induced autoimmune hepatitis when liver injury develops during minocycline therapy.

• Clinical and Experimental Pediatrics
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• 제51권5호
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• pp.528-532
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• 2008

소아에서 약물 유발성 독성 간염은 비교적 흔하며 대부분 약을 끊으면 호전된다. 특히 항결핵약은 주요 유발 약물이다. 약물 유발성 독성 간염은 자가면역질환을 동반할 수 있으며, 이러한 원인으로 보고된 약제로는 주로 methyldopa, nitrofurantoin, minocycline, interferon 등이고, 항결핵약 보고는 드물다. 저자들은 갑상선염이 동반되고 항결핵약 isoniazid와 rifampin으로 유발된 약물 유발성 자가면역간염을 경험하였기에 국내에서 처음으로 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.155-158
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• 2019

Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.

• 대한한방부인과학회지
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• 제36권4호
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• pp.40-48
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• 2023

Objectives: The purpose of this study is to investigate safety of postpartum herbal medicine by assessing the effect of taking herbal medicine of postpartum period on liver function. Methods: A retrospective chart review was conducted on 167 mothers who underwent liver function tests (LFT) within 3 months before and after childbirth among mothers who gave birth at ○○ Hospital between January 1, 2016 and May 31, 2018. Mothers with abnormally elevated LFT during pregnancy were excluded. Among 167 women, 6 women are herbal-medicine-group took herbal medicine for 5-6 weeks during postpartum period, and 161 patients are general -group who did not take herbal medicine. LFT Variation of Subjects before and after childbirth were compared between the two groups. And subjects who had elevated liver levels above the normal range after delivery were classified separately, the characteristics and causes of changes in liver levels were analyzed, and the presence or absence of drug-induced liver damage was confirmed. Results: Among a total of 167 subjects, there were 5 women in the herbal-medicine-group and 150 women in the general-group who had changes in liver values within the normal range after childbirth. Aspartate transaminase (AST) change before and after childbirth in the herbal-medicine-group was 3.40±1.82, and AST change in the general-group was 2.92±8.59, showing no significant difference between the two groups (p=0.901). Increase of Alanine transaminase (ALT) before and after childbirth in the herbal-medicine-group was 5.60±3.65, and ALT change in the general-group was 8.01±11.81, showing no significant difference between the two groups (p=0.651). There were 12 subjects who had elevated AST, ALT above the normal range after delivery, including 1 in the herbal-medicine-group and 11 in the normal mothers group. Valuation of 1 Subject of the herbal-medicine-group before and after delivery was 17 IU/L of AST and 52 IU/L of ALT. Because results of AST, ALT is under the standard to diagnose to liver damage, she was observed without any treatment. However the cause of AST, ALT elevation was not found in the chart, she was receiving treatment for diabetes and hyperlipidemia. The general-group had an average increase of AST 35.64±22.67 IU/L and ALT 53.00±26.80 IU/L. As a result of analyzing the cause, there were direct causes such as autoimmune hepatitis, chronic hepatitis B, and acute pyelonephritis. Abnormal elevations in liver levels were also found in mothers with hypothyroidism, diabetes, and fever of unknown cause, although they were not direct causes. Conclusions: To investigate the safety of taking herbal medicines, we assess the variation in AST and ALT within 3 months before and after delivery in the herbal-medicine-group and general-group. There was no significant difference between two groups.

• 생물정신의학
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• 제2권1호
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• pp.100-106
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• 1995

직접적인 근거를 제시하기는 힘드나 정신장애에서 자가면역적 요소가 병인적으로 중요하다는 단편적인 보고들이 있다. 특히 바이러스 감염은 정신장애를 유발하거나 나중에 정신장애에 대한 소지를 증가시킬 가능성이 높다. 저자들은 최근에 많은 관심을 끌고 있는 C형 간염 항체(이하 anti-HCV)의 양성율이 자가면역적 관점 및 수혈 외에도 성행위 또는 약물의 존자에서 많다는 전파경로상의 특정 때문에 정신과 환자에서 일반 인구군보다 높을 것으로 추정되어 이를 확인해 보고자 본 연구를 시행하였다. 1992년 12월 초부터 1994년 5월 말까지 정신과에 입원한 환자 중에서 무작위로 효소면역측정법 (Abbott HCV EIA kit) 에 의해서 혈청내 anti-HCV를 검사하였으며, anti-HCV 양성 환자와 anti-HCV 음성인 환자를 구분하여 여러 변인별로 비교 분석하였다. 정신과 입원환자 113명중 12명(10.6%) 에서 anti-HCV 양성이었다. anti-HCV 양성자중 간기능검사상 이상이 있는 경우가 50.0% 로서 이중 83.0%는 주정 의존자였으며, 간기능검사상 정상인 환자의 83.3%는 비주정의존자였다. 정신과 진단별 anti-HCV 양성율은 주정의존 환자의 22.2%, 정신증 환자의 2.3% (주로 양극성장애), 신경증(불안장애, 적응장애)환자의 22.2%에서 anti-HCV 양성이 나타났다. 연령, 출생계절, 임파구(%), 간기능 등 변인에 대한 유의한 상관성은 관찰되지 않았다. 결론적으로 정신과 입원환자는 정상 대조군 (3.0%)에 비해 최소한 3.5배 이상 anti-HCV 양성율이 높으므로 (P<0.05), 이에 대한 주의를 환기시킬 필요가 있다.