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Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
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Nafcillin-Induced Allergic Eosinophilic Cholestatic Hepatitis
Mark V Guido1, Warit Jithpratuck2, Graham E Parks3
1Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
Gastroenterology Research
|July 21, 2017
Summary
Nafcillin can cause a rare form of cholestatic hepatitis, a hypersensitivity reaction often involving eosinophils. Prompt withdrawal of the antibiotic typically leads to symptom resolution.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Immunology
Background:
- Nafcillin is an antibiotic commonly used for bacterial infections.
- Drug-induced liver injury (DILI) is a significant clinical concern.
- Hypersensitivity reactions can manifest with diverse clinical presentations.
Observation:
- A 71-year-old female presented with jaundice, elevated liver enzymes, and eosinophilia after nafcillin treatment.
- Liver biopsy revealed portal tract inflammation with lymphocytes and eosinophils.
- Hepatocellular dysfunction was evident, suggesting a severe liver reaction.
Findings:
- The patient's condition was consistent with a hypersensitivity reaction to nafcillin.
- Literature review confirmed other cases of nafcillin-induced cholestatic hepatitis.
- Eosinophil-mediated immune response is the suspected mechanism.
Implications:
- Discontinuation of nafcillin is crucial for recovery from this adverse reaction.
- Glucocorticoids may be considered in some cases under medical supervision.
- Further research is needed to fully understand the pathophysiology of nafcillin-induced liver injury.
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