Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review

Hepatitis E is an acute self-limiting disease caused by hepatitis E virus (HEV). Recent reports show that HEV can induce chronic hepatitis or be reactivated in immunocompromised hosts. We report a 63-year-old woman with rheumatoid arthritis (RA) who developed hepatitis E during treatment with tocili...

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Main Authors: Hidekazu Ikeuchi, Kana Koinuma, Masao Nakasatomi, Toru Sakairi, Yoriaki Kaneko, Akito Maeshima, Yuichi Yamazaki, Hiroaki Okamoto, Toshihide Mimura, Satoshi Mochida, Yoshihisa Nojima, Keiju Hiromura
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2018/6873276
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author Hidekazu Ikeuchi
Kana Koinuma
Masao Nakasatomi
Toru Sakairi
Yoriaki Kaneko
Akito Maeshima
Yuichi Yamazaki
Hiroaki Okamoto
Toshihide Mimura
Satoshi Mochida
Yoshihisa Nojima
Keiju Hiromura
author_facet Hidekazu Ikeuchi
Kana Koinuma
Masao Nakasatomi
Toru Sakairi
Yoriaki Kaneko
Akito Maeshima
Yuichi Yamazaki
Hiroaki Okamoto
Toshihide Mimura
Satoshi Mochida
Yoshihisa Nojima
Keiju Hiromura
author_sort Hidekazu Ikeuchi
collection DOAJ
description Hepatitis E is an acute self-limiting disease caused by hepatitis E virus (HEV). Recent reports show that HEV can induce chronic hepatitis or be reactivated in immunocompromised hosts. We report a 63-year-old woman with rheumatoid arthritis (RA) who developed hepatitis E during treatment with tocilizumab. Analysis of serially stocked serum samples confirmed that hepatitis was caused by primary infection with HEV and not by viral reactivation. Her liver function improved after discontinuing tocilizumab and remained within the normal range without reactivation of HEV for >5 years after restarting tocilizumab. We also reviewed the published cases of hepatitis E that developed during RA treatment.
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publishDate 2018-01-01
publisher Wiley
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series Case Reports in Rheumatology
spelling doaj-art-b60e05677bdb439bb12c0c05936615dd2025-08-20T03:20:55ZengWileyCase Reports in Rheumatology2090-68892090-68972018-01-01201810.1155/2018/68732766873276Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature ReviewHidekazu Ikeuchi0Kana Koinuma1Masao Nakasatomi2Toru Sakairi3Yoriaki Kaneko4Akito Maeshima5Yuichi Yamazaki6Hiroaki Okamoto7Toshihide Mimura8Satoshi Mochida9Yoshihisa Nojima10Keiju Hiromura11Department of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanDepartment of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanDepartment of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanDepartment of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanDepartment of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanDepartment of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanDepartment of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, JapanDivision of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, JapanDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Saitama, JapanDivision of Gastroenterology and Hepatology Internal Medicine, Saitama Medical University, Saitama, JapanDepartment of Rheumatology and Nephrology, Japan Red Cross Maebashi Hospital, Maebashi, JapanDepartment of Nephrology and Rheumatology, Gunma University Graduate School of Medicine, Maebashi, JapanHepatitis E is an acute self-limiting disease caused by hepatitis E virus (HEV). Recent reports show that HEV can induce chronic hepatitis or be reactivated in immunocompromised hosts. We report a 63-year-old woman with rheumatoid arthritis (RA) who developed hepatitis E during treatment with tocilizumab. Analysis of serially stocked serum samples confirmed that hepatitis was caused by primary infection with HEV and not by viral reactivation. Her liver function improved after discontinuing tocilizumab and remained within the normal range without reactivation of HEV for >5 years after restarting tocilizumab. We also reviewed the published cases of hepatitis E that developed during RA treatment.http://dx.doi.org/10.1155/2018/6873276
spellingShingle Hidekazu Ikeuchi
Kana Koinuma
Masao Nakasatomi
Toru Sakairi
Yoriaki Kaneko
Akito Maeshima
Yuichi Yamazaki
Hiroaki Okamoto
Toshihide Mimura
Satoshi Mochida
Yoshihisa Nojima
Keiju Hiromura
Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
Case Reports in Rheumatology
title Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
title_full Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
title_fullStr Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
title_full_unstemmed Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
title_short Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
title_sort hepatitis e during tocilizumab therapy in a patient with rheumatoid arthritis case report and literature review
url http://dx.doi.org/10.1155/2018/6873276
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