title: Over-the-counter Drug Induced Autoimmune Hepatitis.
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.
authors.affiliation: Department of Internal Medicine, Kitasato University Medical Center, Japan.
authors.forename: Karin
authors.initials: K
authors.lastname: Takeda
authors.forename: Masaya
authors.initials: M
authors.lastname: Oda
authors.forename: Takemichi
authors.initials: T
authors.lastname: Okada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohbu
authors.forename: Masaaki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yokomori
mesh_terms: D001706:Biopsy; D049448:Cholangiopancreatography, Magnetic Resonance; D003937:Diagnosis, Differential; D019693:Hepatitis, Autoimmune / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D004366:Nonprescription Drugs