Advertisement

Digestive Diseases and Sciences

, Volume 58, Issue 11, pp 3362–3367 | Cite as

Infliximab-Related Hepatitis: A Case Study and Literature Review

  • Francisco Colina
  • Aída Molero
  • Begoña Casís
  • Pilar Martínez-Montiel
Case Report

Introduction

Infliximab, a chimeric monoclonal antibody directed against the tumor necrosis factor (TNF) alpha receptor, has been related to several types of drug induced liver injury (DILI), ranging from elevated transaminases without other complications to, rarely, acute liver failure with transplantation or death [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25]. We report a case of hepatitis in a woman with relapsing ulcerative colitis treated with four infusions of infliximab, and we also review all cases of DILI due to infliximab reported in the literature, since the medication was introduced. We have focused on the biopsied cases in order to describe the main pathologic features and their correlation with the symptoms and outcome.

Case Report

A 52-year-old woman was diagnosed with ulcerative colitis with pancolitis and erythema nodosum in 1988. She had a chronic course, but after 2 years she suffered a relapse requiring hospitalization....

Keywords

Adverse reactions Immunomediated hepatitis Autoimmune hepatitis Infliximab related hepatitis TNF blockers TNF alpha 

Abbreviations

TNF

Tumor necrosis factor

DILI

Drug induced liver injury

AIH

Autoimmune hepatitis

Notes

Conflict of interest

None.

References

  1. 1.
    Subramaniam K, Chitturi S, Brown M. Infliximab-induced autoimmune hepatitis in Crohn’s disease treated with budesonide and mycophenolate. Inflamm Bowel Dis. 2011;17:E149–E150.PubMedCrossRefGoogle Scholar
  2. 2.
    Doyle A, Forbes G, Kontorinis N. Autoimmune hepatitis during infliximab therapy for Crohn’s disease: a case report. J Crohns Colitis. 2011;5:253–255.PubMedCrossRefGoogle Scholar
  3. 3.
    Goujon C, Dahel K, Bérard F, Guillot I, Gunera-Saad N. Autoimmune hepatitis in two psoriasis patients treated with infliximab. J Am Acad Dermatol. 2010;63:43–44.CrossRefGoogle Scholar
  4. 4.
    Carlsen KM, Riis L, Madsen OR. Toxic hepatitis induced by infliximab in a patient with rheumatoid arthritis with no relapse after switching to etanercep. Clin Rheumatol. 2009;28:1001–1003.PubMedCrossRefGoogle Scholar
  5. 5.
    Polin Y, Thérien G. Drug-induced hepatitis and lupus during infliximab treatment for psoriasis: case report and literature review. J Cutan Med Surg. 2010;14:100–104.Google Scholar
  6. 6.
    Cravo M, Silva R, Serrano M. Autoimmune hepatitis induced by infliximab in a patient with Crohn’s disease with no relapse after switching to adalimumab. Biodrugs. 2010;24:25–27.PubMedCrossRefGoogle Scholar
  7. 7.
    Thiéfin G, Morelet A, Heurgué A, Diebold MD, Eschard JP. Infliximab-induced hepatitis. Absence of cross-toxicity with etanercept. Joint Bone Spine. 2008;75:737–739.PubMedCrossRefGoogle Scholar
  8. 8.
    Marques M, Magro F, Cardoso H, Carneiro F. Infliximab-induced lupus-like syndrome associated with autoimmune hepatitis. Inflamm Bowel Dis. 2008;14:723–725.PubMedCrossRefGoogle Scholar
  9. 9.
    Ozorio G, McGarity B, Bak H, Jordan AS, Lau H, Marshall C. Autoimmune hepatitis following infliximab therapy for ankylosing spondylitis. Med J Aust. 2007;187:524–526.PubMedGoogle Scholar
  10. 10.
    Tobon GJ, Cañas C, Jaller JJ, Restrepo JC, Anaya JM. Serious liver disease induced by infliximab. Clin Rheumatol. 2007;26:578–581.PubMedCrossRefGoogle Scholar
  11. 11.
    Germano V, Picchianti A, Baccano G, et al. Autoimmune hepatitis associated with infliximab in a patient with psoriatic arthritis. Ann Rheum Dis. 2005;64:1519–1520.PubMedCrossRefGoogle Scholar
  12. 12.
    Ojiro K, Naganuma M, Ebinuma H, et al. Reactivation of hepatitis B in a patient with Crohn’s disease treated using infliximab. J Gastroenterol. 2008;43:397–401.PubMedCrossRefGoogle Scholar
  13. 13.
    Madonia S, Orlando A, Scimeca D, Olivo M, Rossi F, Cottone M. Occult hepatitis B and infliximab-induced HBV reactivation. Inflamm Bowel Dis. 2007;13:508–509.PubMedCrossRefGoogle Scholar
  14. 14.
    Millonig G, Kern M, Ludwiczek O, Nachbaur K, Vogel W. Subfulminant hepatitis B after infliximab in Crohn’s disease: need for HBV-screening? World J Gastroenterol. 2006;12:974–976.PubMedGoogle Scholar
  15. 15.
    Ueno Y, Tanaka S, Shimamoto M, et al. Infliximab therapy for Crohn’s disease in a patient with chronic hepatitis B. Dig Dis Sci. 2005;50:163–165.PubMedCrossRefGoogle Scholar
  16. 16.
    Michel M, Duvoux C, Hezode C, Cherqui D. Fulminant hepatitis after infliximab in a patient with hepatitis B virus treated for and adult onset Still’s disease. J Rheumatol. 2003;30:1624–1625.PubMedGoogle Scholar
  17. 17.
    Kuwabara H, Fukuda A, Tsuda Y, Shibayama Y. Precore mutant hepatitis B virus associated fulminant hepatitis during infliximab therapy for rheumatoid arthritis. Clin Rheumatol. 2010;29:449–450.CrossRefGoogle Scholar
  18. 18.
    Wahie S, Alexandroff A, Reynolds NJ. Hepatitis: a rare, but important, complication of infliximab therapy for psoriasis. Clin Exp Dermatol. 2006;31:460–461.PubMedCrossRefGoogle Scholar
  19. 19.
    Ierardi E, Della Valle N, Nacchiero MC, De Francesco V, Stoppino G, Panella C. Onset of liver damage after a single administration of infliximab in a patient with refractory ulcerative colitis. Clin Drug Invest. 2006;26:673–676.CrossRefGoogle Scholar
  20. 20.
    García Aparicio AM, Rey JR, Sanz AH, Alvarez JS. Successful treatment with etanercep in a patient with hepatotoxicity closely related to infliximab. Clin Rheumatol. 2007;26:811–813.PubMedCrossRefGoogle Scholar
  21. 21.
    Fairhurst A, Sheehan-Dare R. Autoimmune hepatitis associated with infliximab in a patient with palmoplantar pustular psoriasis. Clin Exp Dermatol. 2008;34:402–425.Google Scholar
  22. 22.
    Kluger N, Girard C, Guillot B, Bessis D. Efficiency and safety of etanercep after acute hepatitis induced by infliximab for psoriasis. Acta Derm-Venereol. 2009;89:332–333.PubMedCrossRefGoogle Scholar
  23. 23.
    Soto Fernández S, Gónzalez Carro P, de Pedro Esteban A, et al. Infliximab-induced hepatitis in a patient with Crohn’s disease. Gastroenterol Hepatol. 2006;29:321–322.PubMedCrossRefGoogle Scholar
  24. 24.
    Mancini S, Amarotti E, Vecchio S, Ponz de Leon M, Roncucci L. Infliximab-related hepatitis: discussion of a case and review of the literature. Intern Emerg Med. 2010;5:193–200.PubMedCrossRefGoogle Scholar
  25. 25.
    Menghini VV, Arora AS. Infliximab-associated reversible cholestatic liver disease. Mayo Clin Proc. 2001;76:84–86.PubMedCrossRefGoogle Scholar
  26. 26.
    Scheuer PJ. Classification of chronic viral hepatitis: a need for reassessment. J Hepatol. 1991;13:372–374.PubMedCrossRefGoogle Scholar
  27. 27.
    Marinos G. TNF receptors in patients with chronic hepatitis B viral infection. Gastroenterology. 1995;108:1453–1463.PubMedCrossRefGoogle Scholar
  28. 28.
    Weiler-Normann C, Schramm C. Drug induced liver injury and its relationship to autoimmune hepatitis. J Hepatol. 2011;55:747–749.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Francisco Colina
    • 1
  • Aída Molero
    • 1
  • Begoña Casís
    • 2
  • Pilar Martínez-Montiel
    • 2
  1. 1.Department of PathologyHospital Universitario 12 de OctubreMadridSpain
  2. 2.Departament of GastroenterologyHospital Universitario 12 de OctubreMadridSpain

Personalised recommendations