Evidence map›Paper›PMID 41798763›Full record

ArticleGastroenterology report2026

Drug-induced autoimmune hepatitis due to atorvastatin: a complex clinical case and literature review.

Nancy H Serrano-Pérez, Jeanete S Rodríguez-Martínez, Sandra M Feria-Agudelo, Ana Lilia Morales-Leyte, Jacqueline Cordova-Gallardo

Abstract read
In one paragraph

Article in Gastroenterology report, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nancy H Serrano-PérezSchool of Medicine, National Autonomous University of Mexico, Escolar 411A, Copilco Universidad, Coyoacán, Mexico City, 04510, Mexico.ORCID https://orcid.org/0000-0003-2644-5975
Jeanete S Rodríguez-MartínezSchool of Medicine, National Autonomous University of Mexico, Escolar 411A, Copilco Universidad, Coyoacán, Mexico City, 04510, Mexico.
Sandra M Feria-AgudeloSchool of Medicine, National Autonomous University of Mexico, Escolar 411A, Copilco Universidad, Coyoacán, Mexico City, 04510, Mexico.
Ana Lilia Morales-LeyteSchool of Medicine, National Autonomous University of Mexico, Escolar 411A, Copilco Universidad, Coyoacán, Mexico City, 04510, Mexico.
Jacqueline Cordova-GallardoSchool of Medicine, National Autonomous University of Mexico, Escolar 411A, Copilco Universidad, Coyoacán, Mexico City, 04510, Mexico.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Drug-induced liver injury with autoimmune-like features is an uncommon yet clinically significant adverse effect of several medications, including statins. Although generally considered safe, atorvastatin has been associated with rare cases of hepatotoxicity that mimic autoimmune hepatitis on histology. We describe a 53-year-old woman with recently diagnosed chronic kidney disease who developed progressive jaundice and right upper quadrant pain shortly after starting atorvastatin. Laboratory evaluation revealed a mixed pattern of liver injury with worsening liver function tests, while serologic studies for viral hepatitis, autoimmune markers, and metabolic diseases were negative. Imaging ruled out biliary or structural abnormalities. Liver biopsy showed features compatible with autoimmune hepatitis. Given the diagnostic challenge, particularly in seronegative presentations, causality and phenotype assessment tools are essential. The updated Roussel Uclaf Causality Assessment Method (RUCAM) is a validated, widely used instrument with good reproducibility in both idiosyncratic DILI and drug-induced autoimmune hepatitis (DIAIH). Similarly, although the Simplified Autoimmune Hepatitis Score was developed for idiopathic autoimmune hepatitis, it can help identify immunemediated features in DILI when interpreted in a clinical context. In this patient, a RUCAM and S-AIH score of 6, together with compatible histology and a clear temporal association with atorvastatin, supported the diagnosis of statin-induced autoimmune-like hepatitis. The patient received corticosteroids, achieving marked clinical and biochemical improvement. This case highlights the need to consider DILI with autoimmune features in patients with unexplained liver injury after recent statin exposure. When autoimmune serologies are negative, liver biopsy and structured tools such as updated RUCAM and S-AIH are crucial to establish the diagnosis and guide timely immunosuppressive therapy. Although rare, statin-induced autoimmune-like hepatitis is serious but potentially reversible.

Indexed as

atorvastatindrug-induced autoimmune hepatitisDrug-induced liver injury

Identifiers

PMID41798763
PMCPMC12967216

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.