Doxycycline-Induced Autoimmune Hepatitis

Doxycycline and minocycline are tetracyclines with the potential to cause hepatoxicity. Although autoimmune-like hepatitis from minocycline is well-described, doxycycline-induced autoimmune hepatitis (DIAH) has only been described once. We report a rare case of DIAH with elevated liver enzymes over 5 times the normal upper limit, elevated immunoglobulin G, and high titers of antismooth muscle antibody and antinuclear antibody. By stopping doxycycline, our patient's liver enzymes normalized and immunoglobulin G and autoantibody titers rapidly downtrended. As long-term doxycycline therapy becomes more prevalent to treat acne vulgaris and other skin conditions, DIAH may become more prevalent and recognized.