Citation

Takeda K, Oda M, Okada T, Yamazaki H, Ohbu M, Watanabe M, Yokomori H. Intern. Med. 2016; 55(10): 1293-1297.

Affiliation

Department of Internal Medicine, Kitasato University Medical Center, Japan.

Copyright

(Copyright © 2016, Japanese Society of Internal Medicine)

DOI

10.2169/internalmedicine.55.5509

PMID

27181535

Abstract

A 64-year-old man seeking treatment for a common cold was admitted to our hospital due to symptoms of general fatigue and liver dysfunction. A thorough history review revealed that the patient had recently started taking an over-the-counter (OTC) drug. Drug-induced lymphocyte stimulation tests were positive. Serum markers for autoimmune hepatitis (AIH) were particularly elevated. Liver biopsy revealed spotty necrosis and ceroid-pigmented Kupffer cells and piecemeal necrosis with multiple plasma cells. He responded to corticosteroids, thus suggesting the presence of an immune-mediated component associated with the liver injury. Liver injury after using OTCs should be included in the differential diagnosis for chronic hepatitis with features of AIH.

Language: en