title: A case report: ulcerative colitis, treatment with an antibody against tumor necrosis factor (infliximab), and subsequent liver necrosis.
abstract: In recent years, the use of antibodies against tumor necrosis factor α (TNFα) has expanded in rheumatology, gastroenterology, and dermatology. In addition to the more common side effects such as infections and hypersensitivity reactions, elevations of liver enzymes have been reported during anti-TNFα therapy, although severe liver failure has been extremely uncommon. This report describes a patient with severe liver failure after induction therapy with the TNFα antibody infliximab (Remicade®). A 46-year old female patient received two infusions of infliximab at a dose of 400 mg on weeks 0 and 8 for steroid-dependent ulcerative colitis. Eight weeks after the second infusion, she suffered acute liver failure with necrosis, requiring liver transplantation.
authors.affiliation: Lapland Central Hospital, Rovaniemi, Finland. urpo.kinnunen@lshp.fi
authors.forename: Urpo
authors.initials: U
authors.lastname: Kinnunen
authors.forename: Martti
authors.initials: M
authors.lastname: Färkkilä
authors.forename: Heikki
authors.initials: H
authors.lastname: Mäkisalo
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000473:pathology; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009336:Necrosis / Q000139:chemically induced / Q000175:diagnosis
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab