Open AccessAutoimmune hepatitis and anti-tumor necrosis factor alpha therapy: A single center report of 8 cases
Author(s) -
Susana Rodrigues,
Susana Lopes,
Fernando Magro,
Hélder Cardoso,
Ana Maria Horta e Vale,
Margarida Marques,
Eva Mariz,
Miguel Bernardes,
Joanne Lopes,
Fátima Carneiro,
Guilherme Macedo
Publication year - 2015
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v21.i24.7584
Subject(s) - medicine , autoimmune hepatitis , infliximab , adalimumab , autoimmunity , immunology , tumor necrosis factor alpha , single center , liver biopsy , autoimmune disease , gastroenterology , hepatitis , disease , immune system , biopsy
This article describes cases of anti-tumor necrosis factor (TNF)-α-induced autoimmune hepatitis and evaluates the outcome of these patients in relation to their immunosuppressive strategy. A retrospective analysis of medical records was performed in our center, in order to detect cases of autoimmune hepatitis (AIH) associated with anti-TNF biologic agents. We describe and analyze eight cases of AIH following anti-TNF therapy, 7 with infliximab and 1 with adalimumab. A distinction should be made between induction of autoimmunity and clinically evident autoimmune disease. Liver biopsy is useful in detecting the role of the TNF-α antagonist in the development of AIH. The lack of relapse after discontinuing immunosuppressive therapy favors, as in this case series, an immune-mediated drug reaction as most patients with AIH have a relapse after treatment is suspended. Although AIH related to anti-TNF therapy is rare, a baseline immunological panel along with liver function tests should be performed in all patients with autoimmune disease before starting biologics.