Immune-mediated hepatitis: Basic concepts and treatment.

Immunotherapy with immune checkpoint inhibitors (ICIs) has revolutionized advanced cancer management. Nevertheless, the generalized use of these medications has led to an increase in the incidence of adverse immune-mediated events and the liver is one of the most frequently affected organs. Liver involvement associated with the administration of immunotherapy is known as immune-mediated hepatitis (IMH), whose incidence and clinical characteristics have been described by different authors. It often presents as mild elevations of amino transferase levels, seen in routine blood tests, that spontaneously return to normal, but it can also manifest as severe transaminitis, possibly leading to the permanent discontinuation of treatment. The aim of the following review was to describe the most up-to-date concepts regarding the epidemiology, diagnosis, risk factors, and progression of IMH, as well as its incidence in different types of common cancers, including hepatocellular carcinoma. Treatment recommendations according to the most current guidelines are also provided.

Herbal Medicine in Mexico: A Cause of Hepatotoxicity. A Critical Review.

In Mexico, herbal products are commonly used as therapeutic tools. The analysis of several publications reveals that there are dozens of different herbs and herbal products used for different reasons, some of which have been implicated in causing toxic liver disease. However, methodological aspects limit the attribution of causality, and the precise incidence and clinical manifestations of herb-induced liver injury have not been well characterized. This review outlines the history of traditional herbal medicine in Mexico, critically summarizes the mechanisms and adverse effects of commonly used herbal plants, and examines the regulatory issues regarding the legal use of these products.

Albendazole-induced liver injury: a case report / Lesión hepática inducida por albendazol: reporte de un caso

We report a case of a 47-year-old male, who was referred to the clinical hepatology services at Pablo Tobón Uribe Hospital for evaluation of a jaundice syndrome. After undergoing several exams, we diagnosed hepatic hydatidosis and the patient was treated with albendazole; however, after five months of uninterrupted treatment the patient again consulted and his liver test showed marked hepatocellular damage. This time, the patient was diagnosed with drug-induced liver injury due to albendazole, based on information from the clinical record, history of drug consumption, clinical and laboratory tests improved after discontinuing the medication and after discarding other possible causes; this diagnosis was supported by the CIOMS/RUCAM scale, which showed a "likely" correlation between hepatocellular damage and drug toxicity etiology.

Presentamos el caso de un paciente masculino de 47 años de edad, quien fue remitido al servicio de hepatología clínica del Hospital Pablo Tobón Uribe para el estudio de un síndrome ictérico. Tras realizársele varios análisis, se le diagnosticó hidatidosis hepática y recibió albendazol como terapia, sin embargo, después de cinco meses de tratamiento ininterrumpido consultó nuevamente y su perfil hepático mostró marcado daño hepatocelular. Se le diagnosticó entonces una hepatitis toxica inducida por albendazol basados en la información de la historia clínica, el antecedente de consumo del fármaco, la mejoría clínica y en las pruebas de laboratorio tras suspender el medicamento y después de descartar las otras causas posibles; este diagnóstico fue respaldado por la escala CIOMS/RUCAM, que mostró una correlación probable entre el daño hepatocelular y la etiología toxica farmacológica.

Albendazole-induced liver injury: a case report.

We report a case of a 47-year-old male, who was referred to the clinical hepatology services at Pablo Tobón Uribe Hospital for evaluation of a jaundice syndrome. After undergoing several exams, we diagnosed hepatic hydatidosis and the patient was treated with albendazole; however, after five months of uninterrupted treatment the patient again consulted and his liver test showed marked hepatocellular damage. This time, the patient was diagnosed with drug-induced liver injury due to albendazole, based on information from the clinical record, history of drug consumption, clinical and laboratory tests improved after discontinuing the medication and after discarding other possible causes; this diagnosis was supported by the CIOMS/RUCAM scale, which showed a "likely" correlation between hepatocellular damage and drug toxicity etiology.

Presentamos el caso de un paciente masculino de 47 años de edad, quien fue remitido al servicio de hepatología clínica del Hospital Pablo Tobón Uribe para el estudio de un síndrome ictérico. Tras realizársele varios análisis, se le diagnosticó hidatidosis hepática y recibió albendazol como terapia, sin embargo, después de cinco meses de tratamiento ininterrumpido consultó nuevamente y su perfil hepático mostró marcado daño hepatocelular. Se le diagnosticó entonces una hepatitis toxica inducida por albendazol basados en la información de la historia clínica, el antecedente de consumo del fármaco, la mejoría clínica y en las pruebas de laboratorio tras suspender el medicamento y después de descartar las otras causas posibles; este diagnóstico fue respaldado por la escala CIOMS/RUCAM, que mostró una correlación probable entre el daño hepatocelular y la etiología toxica farmacológica.