Desflurane hepatitis associated with hapten and autoantigen-specific IgG4 antibodies.
BACKGROUND
Three cases of drug-induced liver injury (DILI) have been reported after desflurane anesthesia. However, no previous reports have detected serum autoantibodies such as that reported with DILI from halothane or isoflurane.


RESULTS
We describe the first documentation of cytochrome P450 2E1 IgG4 autoantibodies, as well as 58 kDa endoplasmic reticulum protein and trifluoroacetyl chloride hapten-specific IgG4 antibodies, in a patient who developed DILI after desflurane anesthesia.


CONCLUSIONS
These findings suggest that allergic and autoimmune mechanisms have critical roles in the development of desflurane DILI.
Anderson
James S
JS
Anesthesia Consultants Associated, El Paso, Texas, USA.
Rose
Noel R
NR
Martin
Jackie L
JL
Eger
Edmond I
EI
Njoku
Dolores B
DB
D000328:Adult; D001323:Autoantibodies / Q000096:biosynthesis* / Q000097:blood; D001324:Autoantigens / Q000009:adverse effects / Q000276:immunology*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000276:immunology*; D000077335:Desflurane; D005260:Female; D006241:Haptens / Q000009:adverse effects / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007530:Isoflurane / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000276:immunology
D001323:Autoantibodies; D001324:Autoantigens; D006241:Haptens; D007074:Immunoglobulin G; D000077335:Desflurane; D007530:Isoflurane