For suspected drug-induced autoimmune-like hepatitis after the culprit drug is stopped and there is no advanced fibrosis, how do you decide immunosuppression duration and the relapse-free follow-up interval needed to confidently label it DI-ALH rather than classic AIH?

In cases of possible medication-induced AIH, I typically do not start a steroid-sparing agent and attempt to manage alone with corticosteroids. The duration of steroid use is individualized. If there are no steroid side effects or use concerns (i.e., in an older, diabetic patient), we pursue a slowe...

When there is convincing evidence of DI-AIH, usually confirmed by a good medical history, the patient is treated with a course of steroids until achieving normalization of liver enzymes, trying to taper completely within 3 months. Once stopped, would monitor for relapse frequently, at 2 weeks, month...