Etanercept-induced granulomatous hepatitis as a rare cause of abnormal liver tests

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Peixoto, A (Author) Other; Martins Rocha, T (Author) Other; Santos Antunes, J (Author) Other; Aguiar, F (Author) Other; Bernardes, M (Author) Other; Vaz, C (Author) Other; Pereira, P (Author) Other; Macedo G (Author) FMUP

Journal

Title: Acta Gastro-Enterologica Belgica

Vol. 82

Pages: 93-95

ISSN: 0001-5644

Publisher: ACTA MEDICA BELGICA

Indexing

ISI Web of Knowledge - 2 Citations

Scopus - 2 Citations

Other information

Authenticus ID: P-00Q-CXW

Abstract (EN): The authors report the case of a 76 year-old man with rheumatoid arthritis treated with prednisolone and etanercept. The patient was seen for persistent changes in liver tests lasting for six months, with a mixed pattern. The patient denied intake of new drugs or dietary/herbal supplements. Imaging studies showed mild steatosis. Additional study for chronic liver diseases only revealed positivity for anti-nuclear antibodies. Liver biopsy revealed noncaseating granulomas in some portal tracts. Consequent etiologic study for granulomatous diseases showed negative or normal results. So it was decided to suspend etanercept, with a subsequent gradual improvement on analytical parameters that normalized three months later. To date, only one case of granulomatous liver disease associated with an anti-TNF agent was described in the literature. This case also raises the question whether the development of granulomatous processes associated with anti-TNF agents has been underdiagnosed due to the presence of other concomitant immunosuppressant therapies

Language: English

Type (Professor's evaluation): Scientific