ArticleExperimental and molecular pathology2015
Troxis necrosis, a novel mechanism for drug-induced hepatitis secondary to immunomodulatory therapy.
Article in Experimental and molecular pathology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 7 citations in OpenAlex.
- Mechanisms and consequences of COVID-19 associated liver injury: What can we affirm?World journal of hepatology · 2020Review
- Case Report: Hepatotoxicity Associated with the Use of Hydroxychloroquine in a Patient with COVID-19.The American journal of tropical medicine and hygiene · 2020Article
- The Major Histocompatibility Complex Class II-CD4 Immunologic Synapse in Alcoholic Hepatitis and Autoimmune Liver Pathology: The Role of Aberrant Major Histocompatibility Complex Class II in Hepatocytes.The American journal of pathology · 2020Review
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6 authors at 1 institution in 1 country.
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Abstract
objectivesA case of drug-induced hepatitis mediated by troxis necrosis, a form of autoimmune hepatitis, is described.
methodsClinical data, light and electron microscopy of an ultrasound-guided core needle liver biopsy specimen, were examined to investigate the cause of transaminitis in a 26year old male patient on Cellcept and Plaquenil for the treatment of lupus erythematosus. A systematic PUBMED review of troxis necrosis as the underlying mechanism for drug-induced hepatitis was performed.
resultsLiver function tests (LFTs) were significant for elevated AST (305) and ALT (174); the autoimmune workup was significant for anti-ANA positivity and α-SMA negativity. On light microscopy, the liver biopsy shows focal areas of lymphocytic infiltrates surrounding and forming immunologic synapses with lobular hepatocytes, indicating lobular hepatitis of autoimmune nature. Electron microscopy confirmed the presence of immunologic synapses. Upon cessation of the offending medications, the LFTs returned to baseline with no further intervention. Literature search yielded 7 previously reported cases of drug-induced hepatitis mediated by troxis necrosis.
conclusionTroxis necrosis is a novel mechanism for drug-induced hepatitis, including immunomodulatory medications including a monoclonal anti-TWEAK antibody and Cellcept and Plaquenil, two widely used immunosuppression/anti-rejection medications.
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