Drug-induced hepatitis with hepatic granuloma due to saridon

Abstract

A 38-year-old Japanese woman with no past history of liver disease developed liver dysfunction associated with fever, anorexia, and general malaise following the prolonged administration of saridon. A liver biopsy demonstrated multiple noncaseating epithelioid granulomas within hepatic lobules, with an inflammatory cell infiltrate of the lobular parenchyma and portal tracts. Viral markers and autoantibodies were negative. Lymphocyte stimulation tests for saridon and for isopropylantipyrine, one of the constituents of saridon, were positive, and therefore a diagnosis of drug-induced hepatitis due to administration of saridon was made. Her symptoms resolved and liver function test results returned to normal following discontinuation of the drug. The possibility of drug-induced hepatitis must be considered when liver dysfunction or systemic symptomatology develops during saridon therapy.

Abatacept induced granulomatous hepatitis with a sarcoidosis- like reaction: a blinded trial in mice

“…Previous literature does not reflect the magnitude of drug–induced granulomatous hepatic disease and that many cases reported as “granulomatous hepatitis” consistent with “sarcoidosis” as well as many “undiagnosed” cases have a drug etiology. There have recently been reports of hepatic granulomas induced by drugs that had not previously been considered to be causal of this condition, and we therefore believe that many more drugs may potentially play a role in the development of hepatic granuloma [34, 39, 40].…”