A Severe Autoimmune-like Anti-Tuberculosis Drug-induced Liver Injury: Case Report and Review

Jorge R. Mosqueira¹, Sue Anicama², Jorge De Los Ríos³

¹Médico Cirujano, Universidad Peruana Cayetano Heredia, Departamento de Medicina Interna, Hospital María Auxiliadora, Lima, Perú

²Médico Cirujano, Universidad de San Martín de Porres, Lima, Perú

³Jefe del Servicio de Neumología “CENEX Niño Jesús”, Hospital María Auxiliadora, Lima, Perú

ABSTRACT

Drug-induced liver injury is one of the most significant adverse drugs reactions and, in severe cases, could be a potentially life-threatening condition. It can be classified in intrinsic and idiosyncratic reactions and, anti-tuberculous drugs are known to induce the later one. In some cases, it might develop some autoimmune features which represent a challenge for both diagnosis and treatment. We report a 37-year-old woman who was admitted to our hospital with signs of severe acute liver injury. She was diagnosed with autoimmune-like drug-induced liver injury by anti-tuberculous drugs and was treated with corticosteroids, N-Acetylcysteine and Ursodesoxycholic acid. Indeed, based on this case a review of the literature is presented. J Microbiol Infect Dis 2018; 8(3):128-134

Keywords: Anti-tuberculous drugs; Corticosteroids; Drug-induced Liver Injury, N-Acetylcysteine, Tuberculosis