Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn’s Disease: A Case Report

Goel, Kanika; Bunker, Mark; Balog, Anna; Silverman, Jan F.

doi:10.1177/1179547619858979

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…The severity of reported cases of primary varicella [207] and HSV infection [208][209][210] strongly support immunosuppressant withdrawal. HZ is one of the most frequent opportunistic infections observed in immunosuppressed IBD patients and is particularly associated with thiopurines and tofacitinib.…”

Section: Immunosuppressive Treatment During Viral Infectionsmentioning

confidence: 92%

ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

Kucharzik

Ellul

Greuter

et al. 2021

Journal of Crohn's and Colitis

280

235

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Section: Immunosuppressive Treatment During Viral Infectionsmentioning

confidence: 92%

ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

Kucharzik

Ellul

Greuter

et al. 2021

Journal of Crohn's and Colitis

280

235

View full text Add to dashboard Cite

“…These include a heightened risk of serious infections, increased likelihood of certain cancers, and the possibility of anaphylactic reactions [ 44 , 45 ]. Additionally, there is a concern for the reactivation of hepatitis B in carriers [ 46 , 47 ]. The drug may also trigger new onset or worsen existing demyelinating diseases, such as multiple sclerosis [ 48 – 53 ], and has been linked to heart and liver failure [ 54 , 55 ], as well as rare cases of autoimmune hemolytic anemia [ 56 – 58 ].…”

Section: Discussionmentioning

confidence: 99%

Case Report: Effective management of adalimumab-induced acquired hemophilia A with the CyDRI protocol

Ceglédi,

Bátai,

Dolgos

et al. 2024

Pathol. Oncol. Res.

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IntroductionAcquired Hemophilia A (AHA) is a rare autoimmune disorder characterized by the emergence of inhibitors that specifically target coagulation Factor VIII, frequently resulting in severe bleeding episodes.MethodsWe conducted a retrospective analysis of the medical records of a 68-year-old male patient who presented with adalimumab-induced AHA.ResultsThe patient received adalimumab, a tumor necrosis factor inhibitor antibody, as part of his treatment for rheumatoid arthritis. The patient’s clinical journey, characterized by intense bleeding and coagulopathy, was effectively managed with the application of recombinant Factor VIIa (rFVIIa) and the CyDRi protocol.DiscussionThe case emphasizes the importance of prompt coagulation assessment in patients with bleeding symptoms receiving disease-modifying therapy for rheumatoid arthritis that includes adalimumab therapy, considering the rare yet life-threatening nature of AHA. Additionally, this report provides an extensive review of the existing literature on drug-induced AHA, with a special emphasis on cases linked to immunomodulatory medications. Through this two-pronged approach, our report aims to enhance understanding and awareness of this severe complication among healthcare providers, promoting timely diagnosis and intervention.

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“…Within the treatment regimens for IBD, corticosteroids and azathioprine have been related to skin or genital herpetic flares[ 30 , 127 ]. Extended HSV colitis associated with IBD exacerbations are largely reported[ 128 - 132 ]. The testing approach depends upon the site of the disease (mucocutaneous, ocular, neurologic or visceral).…”

Section: Viral Diseasesmentioning

confidence: 99%

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Craviotto¹,

Furfaro²,

Loy³

et al. 2021

WJG

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Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’ lives. This practical review supports this standard of care to improve knowledge in this subject area.

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Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn’s Disease: A Case Report

Cited by 6 publications

References 21 publications

ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

Case Report: Effective management of adalimumab-induced acquired hemophilia A with the CyDRI protocol

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

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