Work

Desflurane Hepatitis Associated with Hapten and Autoantigen-Specific IgG4 Antibodies

Year: 2007

Type: article

Abstract: In Brief BACKGROUND: Three cases of drug-induced liver injury (DILI) have been reported after desflurane anesthesia. However, no previous reports have detected serum autoantibodies such as that reported with DILI from halothane or isoflurane. METHODS AND RESULTS: We describe the first documentation of cytochrome P450 2E1 IgG4 autoantibodies, as well as 58 kDa endoplasmic reticulum protein and trifluoroacetyl chloride hapten-specific IgG4 antibodies, in a patient who developed DILI after desflurane anesthesia. CONCLUSIONS: These findings suggest that allergic and autoimmune mechanisms have critical roles in the development of desflurane DILI. IMPLICATIONS: We provide the first documentation of cytochrome P450 2E1 IgG4 autoantibodies, as well as 58 kDa endoplasmic reticulum protein and trifluoroacetyl chloride hapten-specific IgG4 antibodies, in a patient who developed hepatitis after desflurane anesthesia. These findings suggest that allergic and autoimmune mechanisms have critical roles in the development of desflurane-induced liver injury.

Source: Anesthesia & Analgesia

DOI: 10.1213/01.ane.0000263275.10081.47

Authors: James S. Anderson, Noel R. Rose, Jackie L. Martin, Edmond I. Eger, Dolores B. Njoku

Institutions: Johns Hopkins University, Johns Hopkins Medicine, Johns Hopkins Hospital, University of California, San Francisco

Language: English

Topic: Drug-Induced Hepatotoxicity and Protection

Subfield: Pharmacology

Field: Pharmacology, Toxicology and Pharmaceutics

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: green

Funder: National Institute of Diabetes and Digestive and Kidney Diseases