Abstract: Objective The purpose of this study was to summarize clinical feature of patients with drug-induced autoimmune-like hepatitis(DI-ALH). Method A retrospective analysis was conducted on clinical data of patients with drug-induced liver injury (DILI) in our hospital between January 2018 and January 2023, and all patients underwent liver biopsies. Immunosuppressant was given to those with autoimmune phenomenon. Result Of 312 patients with DILI, DI-ALH was found in 73 patients who presented as persistent liver injury after discontinuation of suspected medicine, elevated serum globulin level, and positive autoantibodies; percentage of herbal medicine-induced liver injury (HILI) in patients with DI-ALH was much higher than in patients with DILI(P＜0.05), serum cholinesterase level was much lower, while total serum bile acid (TBA), bilirubin, globumin and IgG levels were much higher than in patients with DILI (P＜0.05); liver histo-pathological injuries were more severe in patients with DI-ALH; of 70 patients with DI-ALH receiving immunosuppressant, disease remission (DR) rate was found as 48.6% and incomplete response (ICR) was 51.4% after three month treatment; baseline serum IgG levels in patients with ICR was much higher than in those with DR (P＜0.05), and liver injuries in ICR group were more severe (P＜0.05). Conclusion Autoimmune reaction might be involved in patients with DILI, especially in those who take herbal medicine, immunosuppressant might be tentatively given and the long-term efficacy still need observation.

Key words: Drug-induced autoimmune-like hepatitis, Clinical feature, Immunosuppressant, Therapy