Autoimmune-like hepatitis induced by drugs: Still many unanswered questions

Table 1 Indications and drugs linked to drug-induced autoimmune-like hepatitis

Drug	Therapeutic indication	Association with DI-AIH
Minocycline	Acne vulgaris, rosacea	Frequently reported in young females
Nitrofurantoin	Recurrent UTIs	Often presents with ANA and ASMA positivity
Methyldopa	Hypertension (especially in pregnancy)	Classical example of DI-AIH
Hydralazine	Hypertension, heart failure	Can induce lupus-like syndrome and DI-AIH
Statins (atorvastatin, rosuvastatin)	Hyperlipidemia	Increasingly reported; often presents with mild phenotype
Infliximab	Rheumatoid arthritis, Crohn’s disease, psoriasis	Anti-TNFα-induced AIH described in several cases
Adalimumab	Rheumatoid arthritis, psoriasis, ulcerative colitis	Rare, but documented in literature
Interferon-α	Chronic hepatitis B/C, certain cancers	May trigger or unmask autoimmune hepatitis
Tyrosine kinase inhibitors (e.g., imatinib)	CML, GIST	Rare cases reported

UTIs: Urinary tract infections; CML: Chronic myeloid leukemia; ANA: Antinuclear antibody; ASMA: Anti-smooth muscle antibody; DI-ALH: Drug-induced autoimmune -like hepatitis; TNFα: Tumor necrosis factor α; AIH: Autoimmune hepatitis; GIST: Gastrointestinal stromal tumor.