title: [Infliximab-induced hepatitis during treatment of vulvar Crohn's disease].
abstract: BACKGROUND
  We report a case of acute cytolytic hepatitis induced by infliximab in a patient with severe vulvar Crohn's disease.
  
  
  METHODS
  A 29-year-old Congolese woman presented with severe vulvar Crohn's disease active for 7 years. In view of resistance to standard medication (corticosteroids and metronidazole), treatment with infliximab 5mg/kg per injection was initiated. The patient developed acute cytolytic hepatitis 10 days after the first injection and the disease was asymptomatic. The various investigations confirmed the direct cytotoxicity of infliximab. A favourable outcome was gradually achieved after increasing the dosage of corticosteroids. At the same time, an improvement in the vulvar lesions was noted after this sole injection.
  
  
  CONCLUSIONS
  Infliximab-induced is rare, with only 20 reported cases. The physiopathological mechanism is unknown and a number of aetiologies have been suggested.
  
  
  CONCLUSIONS
  This new case raises the issue of the need for routine liver function testing during infliximab therapy given the asymptomatic nature of this effect.
authors: Service de dermatologie, CHU de Nantes, 3, place Alexis-Ricordeau, 44000 Nantes, France. sylviecausse@gmail.com
authors: S
authors: S
authors: Caussé
authors: R
authors: R
authors: Bouquin
authors: S
authors: S
authors: Wylomanski
authors: M
authors: M
authors: Flamant
authors: M
authors: M
authors: Joubert
authors: B
authors: B
authors: Dréno
authors: G
authors: G
authors: Quéreux
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003424:Crohn Disease / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000069285:Infliximab; D007275:Injections, Intravenous; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008111:Liver Function Tests; D011241:Prednisone / Q000627:therapeutic use; D014845:Vulvar Diseases / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab; D011241:Prednisone