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Azithromycin-Induced Liver Injury in an Asthma Exacerbation Patient With Autoimmune Features

Richard Liang1, Adesh Ramdass2

  • 1Medicine, New York Institute of Technology College of Osteopathic Medicine, Glen Head, USA.

Cureus
|July 1, 2022
PubMed

Insights

Drug-induced liver injury (DILI) from azithromycin is rare but serious. This case highlights the diagnostic challenge of differentiating DILI from autoimmune hepatitis (AIH) in asthma patients.

Area of Science:

  • Hepatology
  • Clinical Pharmacology
  • Immunology

Background:

  • Drug-induced liver injury (DILI) is a significant cause of acute liver failure in the US.
  • Antimicrobials are frequently implicated in DILI.
  • Azithromycin, while generally safe, can rarely cause DILI.

Observation:

  • A patient with asthma exacerbation presented with liver injury.
  • The presentation mimicked autoimmune hepatitis (AIH).
  • Azithromycin was identified as the potential causative agent.

Findings:

  • The case illustrates the diagnostic difficulty in distinguishing azithromycin-induced liver injury from AIH.
  • A liver biopsy may be necessary for definitive diagnosis.
  • This case highlights a rare but severe adverse effect of azithromycin.

Implications:

  • Increased awareness of azithromycin-induced DILI is crucial for clinicians.
  • Differential diagnosis of DILI and AIH requires careful consideration.
  • Prompt recognition and management are vital for patient outcomes.
Keywords:
acute hepatitisasthma exacerbationautoimmune hepatitisazithromycindrug-induced liver injury

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