Infliximab-induced lupus-like syndrome associated with autoimmune hepatitis

Abstract

A 38-year-old woman was admitted to our department because of a progressive, painful ulceration on the left heel pad. Fifteen years ago she had been diagnosed with ulcerative colitis (UC) involving the entire colon. She has maintained disease remission with 5-aminosalicylic acid treatment

Infliximab-induced autoimmune hepatitis in Crohnʼs disease treated with budesonide and mycophenolate

“…Only one of the four reported cases had an elevated ANA titer (1:320). 4 Advanced hepatic fibrosis has not been observed in either of two cases with available histology. 1,4 Only one of the cases had a definitive response to oral steroids.…”

“…4 Advanced hepatic fibrosis has not been observed in either of two cases with available histology. 1,4 Only one of the cases had a definitive response to oral steroids. It is significant that our case had histological evidence of advanced fibrosis after only 5 months of therapy.…”

“…To the best of our knowledge, there are only four reported cases of infliximab-induced autoimmune hepatitis in patients with inflammatory bowel disease. [1][2][3][4] Infliximab hepatitis appears indistinguishable from autoimmune hepatitis type 1 but direct hepatotoxicity cannot be excluded. Only one of the four reported cases had an elevated ANA titer (1:320).…”

Autoimmune hepatitis induced by adalimumab with successful switch to abatacept

“…The BIOGEAS registry reported 19 cases of AIH related to anti-TNF therapy. Fifteen detailed case reports were published: 12 induced by infliximab, 2 by etanercept, and 1 by adalimumab [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Table 1 summarizes the 16 cases (15 previous published and our case).…”

Clinical Presentation and Outcomes of Autoimmune Hepatitis in Inflammatory Bowel Disease

“…Typical medications used for inflammatory bowel disease include aminosalicylates, methotrexate, and various biologics including antitumor necrosis factor (TNF) alpha drugs. At least eleven cases have been reported to date of autoimmune hepatitis in patients treated with infliximab therapy [35][36][37][38][39][40][41][42][43][44][45][46][47]. Etanercept has also been found to exacerbate AIH [48].…”