The Straw That Broke the Camel’s Back: Amoxicillin-Clavulanate Unraveling Autoimmune Hepatitis in a Previously Asymptomatic Female

Drug-induced liver injury (DILI) is a challenging diagnosis. Treatment generally involves cessation of the offending agent. In rare cases, DILI may present with autoimmune features that may necessitate immunosuppressive treatment, as in drug-induced autoimmune hepatitis (DIAIH). Distinguishing DIAIH from classic idiopathic autoimmune hepatitis (cAIH) may be difficult, as cAIH can also present after DILI and typically requires long-term immunosuppression for treatment. We describe a case of a 61-year-old female who presented with jaundice and abnormal liver function tests several months after taking amoxicillin-clavulanate. A comprehensive workup with long-term monitoring later revealed the cause of her condition, an unusual diagnosis in a previously healthy individual.