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Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report

INTRODUCTION: Infliximab, an antibody against tumor necrosis factor alpha, is used to treat inflammatory bowel disease and has well-established efficacy and proven safety. Complications of this treatment are related to immunosuppression and include higher risk of serious infections and malignant neo...

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Autores principales: Parra, Rogerio Serafim, Feitosa, Marley Ribeiro, Machado, Vanessa Foresto, Ramalho, Leandra Naira Zambelli, Rocha, Jose Joaquim Ribeiro da, Feres, Omar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4627392/
https://www.ncbi.nlm.nih.gov/pubmed/26518665
http://dx.doi.org/10.1186/s13256-015-0730-5
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author Parra, Rogerio Serafim
Feitosa, Marley Ribeiro
Machado, Vanessa Foresto
Ramalho, Leandra Naira Zambelli
Rocha, Jose Joaquim Ribeiro da
Feres, Omar
author_facet Parra, Rogerio Serafim
Feitosa, Marley Ribeiro
Machado, Vanessa Foresto
Ramalho, Leandra Naira Zambelli
Rocha, Jose Joaquim Ribeiro da
Feres, Omar
author_sort Parra, Rogerio Serafim
collection PubMed
description INTRODUCTION: Infliximab, an antibody against tumor necrosis factor alpha, is used to treat inflammatory bowel disease and has well-established efficacy and proven safety. Complications of this treatment are related to immunosuppression and include higher risk of serious infections and malignant neoplasia. Although extremely rare, fulminant liver damage related to infliximab therapy has been reported. CASE PRESENTATION: We present the case of a 38-year-old Afro-Brazilian woman with refractory ulcerative colitis who was started on infliximab. She had no previous history of liver disease, alcohol abuse, or infection. After the fifth dose of the medication, drug-induced liver injury was diagnosed. Treatment was discontinued but our patient’s condition was aggravated by severe cholestasis and grade III/IV encephalopathy, requiring liver transplantation. CONCLUSION: Drug-induced liver injury is an uncommon complication of infliximab. Current consensus recommends screening for liver dysfunction prior to and during therapy. This case emphasizes the need for vigilance and highlights a rare and potentially lethal complication.
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spelling pubmed-46273922015-10-31 Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report Parra, Rogerio Serafim Feitosa, Marley Ribeiro Machado, Vanessa Foresto Ramalho, Leandra Naira Zambelli Rocha, Jose Joaquim Ribeiro da Feres, Omar J Med Case Rep Case Report INTRODUCTION: Infliximab, an antibody against tumor necrosis factor alpha, is used to treat inflammatory bowel disease and has well-established efficacy and proven safety. Complications of this treatment are related to immunosuppression and include higher risk of serious infections and malignant neoplasia. Although extremely rare, fulminant liver damage related to infliximab therapy has been reported. CASE PRESENTATION: We present the case of a 38-year-old Afro-Brazilian woman with refractory ulcerative colitis who was started on infliximab. She had no previous history of liver disease, alcohol abuse, or infection. After the fifth dose of the medication, drug-induced liver injury was diagnosed. Treatment was discontinued but our patient’s condition was aggravated by severe cholestasis and grade III/IV encephalopathy, requiring liver transplantation. CONCLUSION: Drug-induced liver injury is an uncommon complication of infliximab. Current consensus recommends screening for liver dysfunction prior to and during therapy. This case emphasizes the need for vigilance and highlights a rare and potentially lethal complication. BioMed Central 2015-10-30 /pmc/articles/PMC4627392/ /pubmed/26518665 http://dx.doi.org/10.1186/s13256-015-0730-5 Text en © Parra et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Parra, Rogerio Serafim
Feitosa, Marley Ribeiro
Machado, Vanessa Foresto
Ramalho, Leandra Naira Zambelli
Rocha, Jose Joaquim Ribeiro da
Feres, Omar
Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
title Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
title_full Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
title_fullStr Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
title_full_unstemmed Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
title_short Infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
title_sort infliximab-associated fulminant hepatic failure in ulcerative colitis: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4627392/
https://www.ncbi.nlm.nih.gov/pubmed/26518665
http://dx.doi.org/10.1186/s13256-015-0730-5
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