Drug-induced lupus and autoimmune hepatitis secondary to infliximab for psoriasis

Dang, Lucy J; Lubel, John S; Gunatheesan, Shyamalar; Hosking, Patrick; Su, John

doi:10.1111/ajd.12054

Cited by 29 publications

(23 citation statements)

References 20 publications

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“…The reported characteristics included female predilection, positive ANA and anti-double-stranded DNA autoantibodies resembling systemic lupus erythematosus [206][207][208]. Whether infliximab induces AIH remains controversial [209], especially in light of recent reports of its efficacy as an alternative therapy for refractory AIH [204,205].…”

Section: Infliximabmentioning

confidence: 99%

Autoimmune hepatitis

Sahebjam

Vierling

2015

Front. Med.

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Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte-specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to identification of specific diagnostic and prognostic biomarkers and new therapeutic strategies.

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Section: Infliximabmentioning

confidence: 99%

Autoimmune hepatitis

Sahebjam

Vierling

2015

Front. Med.

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“…Other agents used in combination with steroids include azathioprine and ustekinumab [35]. In two of the reported cases, AIH resolved with switching to another biologic agent such as adalimumab suggesting an absence of cross-reactivity [38,39].…”

Section: Medication-induced Aihmentioning

confidence: 87%

“…Typical medications used for inflammatory bowel disease include aminosalicylates, methotrexate, and various biologics including antitumor necrosis factor (TNF) alpha drugs. At least eleven cases have been reported to date of autoimmune hepatitis in patients treated with infliximab therapy [35][36][37][38][39][40][41][42][43][44][45][46][47]. Etanercept has also been found to exacerbate AIH [48].…”

Section: Medication-induced Aihmentioning

confidence: 99%

Clinical Presentation and Outcomes of Autoimmune Hepatitis in Inflammatory Bowel Disease

DeFilippis

Kumar

2015

Dig Dis Sci

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Nearly one-third of patients with inflammatory bowel disease (IBD) have abnormal liver tests, which can be indicative of underlying hepatic disease. Primary sclerosing cholangitis has a clear association with ulcerative colitis, but other autoimmune disorders such as autoimmune hepatitis (AIH) have also been associated with IBD. AIH may also occur in the setting of an overlap syndrome or in the setting of medications, particularly tumor necrosis factor alpha inhibitors. Importantly, some studies have shown that IBD patients with AIH fail treatment more frequently than IBD patients without AIH. This review will focus on the clinical characteristics, diagnosis, and management of autoimmune hepatitis in inflammatory bowel disease patients.

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“…In a single center, off-label study of 11 AIH patients who failed standard immunosuppression, infliximab therapy significantly decreased mean AST levels ( 475 U/L to 43 U/L) and mean IgG levels (24.8 mg/dL to 17.4 mg/dL) 189 . Reports that either infliximab [191][192][193][194] or adalimumab 153,195,196 can cause DILI resembling AIH are disturbing. Whether infliximab causes de novo AIH remains controversial 197 .…”

Section: Alternative Immunosuppressive Therapiesmentioning

confidence: 99%

Autoimmune Hepatitis and Overlap Syndromes: Diagnosis and Management

Vierling

2015

Clinical Gastroenterology and Hepatology

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Drug-induced lupus and autoimmune hepatitis secondary to infliximab for psoriasis

Cited by 29 publications

References 20 publications

Autoimmune hepatitis

Autoimmune hepatitis

Clinical Presentation and Outcomes of Autoimmune Hepatitis in Inflammatory Bowel Disease

Autoimmune Hepatitis and Overlap Syndromes: Diagnosis and Management

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