Autoimmune disease is characterized by the immune system attacking cells in the body that it normally protects. The National Digestive Diseases Information Clearinghouse explains that certain toxins and drugs trigger an autoimmune response in people genetically susceptible to developing autoimmune disorders. Autoimmune diseases of the liver refer to a range of dysfunction and inflammation in which the immune system attacks liver cells, causing damage in the form of hepatitis or, in severe cases, cirrhosis and full liver failure. The "Journal of Clinical Pathology" notes that intrinsic hepatoxicity is damage directly induced by a drug; idiosyncratic hepatoxicity results from indirect damage to the liver from a drug metabolizing at toxic levels in the liver.
Acute Hepatitis in Women
According to the "Western Journal of Medicine," drug- or alcohol-induced autoimmune liver disease in women is a higher risk than in men due to higher blood ethanol concentration. Compared to men, women have more fat stored in the body, which increases the rate of absorption of alcohol and drugs, enhancing the adverse effects. This is significant for women treating high blood pressure with drugs containing methyldopa. Methyldopa relaxes the blood vessels for easier blood flow, but causes hepatoxicity, leading to type 1 hepatitis. Depending on the type and amount of damage done to the liver, cessation of the drug can result in resolution of the hepatitis.
Sudden Hepatoxicity and Acetaminophen
Acetaminophen is a common over-the-counter drug useful in relieving minor aches and pain. According to the "Journal of Clinical Pathology," acetaminophen toxicity is responsible for nearly 40 percent of sudden and acute liver failure incidences in a given year. High dosages of acetaminophen cause toxic properties---it becomes a poison and changes the way the drug metabolizes so that the body begins to attack the liver---in many cases, within 96 hours of ingestion.
Cirrhosis and Methotrexate
Methotrexate is a drug used to treat the skin condition psoriasis, and when taken for long periods of time, causes liver damage. Primary biliary cirrhosis is a chronic liver condition related to immune system dysfunction, notes the California Pacific Medical Center. A 1990 Baylor University study in Dallas, Texas, conducted by physicians Stanley Gilbert, Goran Klintmalm, Alan Menter and Alan Silverman reported in the "Archives of Internal Medicine" concluded that in three specific participant cases, the medication methotrexate induced cirrhosis of the liver severe enough to warrant liver transplantation in the study subjects.
Minocycline and Liver Fibrosis
The drug minocycline is an antibiotic used primarily in treating urinary tract infections, acne and sexually transmitted diseases. The "Journal of Clinical Pathology" indicates that using this medication long-term leads to autoimmune liver disease, often within days of starting the medication, and depending on individual susceptibility. In rare cases, minocycline causes fibrosis---an excess of protein in the liver---cirrhosis or full liver failure.
References
- Merck Manuals Online Medical Library: Liver Injury Caused by Drugs
- National Digestive Diseases Information Clearinghouse: Autoimmune Hepatitis
- California Pacific Medical Center: Primary Biliary Cirrhosis
- "Western Journal of Medicine"; Liver Disease in Women. Alcohol, Autoimmunity, and Gallstones; Sheila Sherlock; December 1988
- "Journal of Clinical Pathology"; Histological Patterns In Drug-Induced Liver Disease; R. Ramachandran, S. Kakar; December 2008
