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dc:titleAcute hepatitis in a paediatric patient: immune-mediated drug-induced liver injury or albendazole-induced autoimmune hepatitis?
dc:creatorNataša, Dragutinović
dc:creatorBarać, Aleksandra
dc:creatorGoran, Stevanović
dc:creatorIrena, Đorđić
dc:creatorBianca, Paglietti
dc:creatorJelena, Micić
dc:creatorAleksić, Ema
dc:creatorNestorov Jelena, Martinov
dc:subjectdrug-induced liver injury
dc:subjectalbendazole
dc:subjectautoimmune hepatitis
dc:subjectpediatric patients
dc:subjectIgG elevation
dc:subjectanti-smooth muscle antibodies
dc:subjectprednisolone
dc:subjectparasitic disease treatment
dc:subjectcholestasis
dc:subjectelevated liver enzymes
dc:descriptionINTRODUCTION: Drug-induced liver injury (DILI) is one of the most common causes of liver damage. A large number of drugs, dietary supplements, and herbal medications can cause hepatotoxicity. In some situations, it is difficult to distinguish between DILI and autoimmune hepatitis, especially when the mechanism is immune-mediated. Albendazole is a drug that has been used for decades for the treatment of parasitic infections in humans. One of the side effects is liver enzyme elevation, but rarely requires the discontinuation of therapy. Previous experience has shown that hypersensitivity is the most common mechanism of albendazole hepatotoxicity. CASE REPORT: Here we presented a paediatric patient in whom albendazole induced severe liver injury. In laboratory analyses, in addition to markedly elevated transaminases and parameters of cholestasis, there was also a significant increase in IgG, so autoimmune hepatitis was considered. Even though the liver histology indicated toxic liver disease, prednisolone was started. Corticosteroid therapy resulted in the complete normalization of liver function, as well as IgG. With the cessation of corticosteroid therapy, transaminases, bilirubin and gamma-glutamyl transferase (GGT) remained within normal levels, but an increase in anti-smooth muscle antibodies (SMA) was noted in immunological analyses after one year of follow-up. CONCLUSIONS: Immune-mediated hepatotoxicity from albendazole is one possible mechanism of liver injury. The use of albendazole in the treatment of parasitic infections, especially in children, requires close monitoring. The question remains as to whether albendazole is a drug that can induce autoimmune hepatitis in the paediatric population.
dc:publisherOpen Learning on Enteric Pathogens
dc:date2022
dc:typeinfo:eu-repo/semantics/article
dc:typeinfo:eu-repo/semantics/publishedVersion
dc:identifierhttps://stomatoloskifakultet.rs/nauka/publikacija/650
dc:identifierDOI 10.3855/jidc.16594
dc:identifierISSN 1972-2680
dc:sourceThe Journal of Infection in Developing Countries (JIDC) 16(10): 1660-1663
dc:languageen
dc:rightsinfo:eu-repo/semantics/closedAccess
dc:rightsSva prava zadržana