title: Precore mutant hepatitis B virus-associated fulminant hepatitis during infliximab therapy for rheumatoid arthritis.
abstract: A 73-year-old female, who suffered from rheumatoid arthritis for 10 years, developed precore mutant hepatitis B virus-associated fulminant hepatitis after 1 year of infliximab therapy and subsequent methotrexate withdrawal. We emphasize the importance of preemptive antiviral therapy before starting infliximab administration and withdrawing immunosuppressive drugs.
authors.affiliation: Department of Pathology, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. pa2020@art.osaka-med.ac.jp
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kuwabara
authors.forename: Akira
authors.initials: A
authors.lastname: Fukuda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tsuda
authors.forename: Yuro
authors.initials: Y
authors.lastname: Shibayama
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000473:pathology / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000276:immunology / Q000473:pathology; D006512:Hepatitis B Core Antigens / Q000097:blood / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008727:Methotrexate / Q000627:therapeutic use; D009154:Mutation; D028761:Withholding Treatment
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D007166:Immunosuppressive Agents; D000069285:Infliximab; D008727:Methotrexate