Autoimmune Hepatitis Due to Para-Aminobenzoic Acid

    Eric Lorio, Karthik Garapati, Amy E. Schindler, Fermin O. Tio
    TLDR Para-aminobenzoic acid in hair supplements can cause autoimmune hepatitis.
    A 37-year-old female with ulcerative colitis developed autoimmune hepatitis (AIH) after taking a hair supplement containing para-aminobenzoic acid (PABA). Despite initial treatment with prednisone, her liver function tests (LFTs) worsened, peaking at AST 2310 U/L and ALT 3061 U/L. A liver biopsy confirmed acute hepatitis, and elevated anti-SMA and serum IgG levels supported the AIH diagnosis. She was treated with prednisone and azathioprine, which normalized her LFTs. One year later, she remained asymptomatic on azathioprine. This case highlighted PABA as a previously unreported cause of drug-induced AIH, emphasizing caution with its use.
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