Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease
Background. Tocilizumab, a monoclonal humanized anti-IL-6 receptor antibody, is used in treatment of refractory adult onset Still’s disease (AOSD). Mild to moderate liver enzyme elevation is a well-known side effect, but severe liver injury has only been reported in 3 cases in the literature. Case....
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2013/964828 |
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| author | Michael Drepper Laura Rubbia-Brandt Laurent Spahr |
| author_facet | Michael Drepper Laura Rubbia-Brandt Laurent Spahr |
| author_sort | Michael Drepper |
| collection | DOAJ |
| description | Background. Tocilizumab, a monoclonal humanized anti-IL-6 receptor antibody, is used in treatment of refractory adult onset Still’s disease (AOSD). Mild to moderate liver enzyme elevation is a well-known side effect, but severe liver injury has only been reported in 3 cases in the literature. Case. A young female suffering from corticoid and methotrexate refractory AOSD was treated by tocilizumab. After 19 months of consecutive treatment, she developed acute severe liver injury. Liver biopsy showed extensive hepatocellular necrosis with ballooned hepatocytes, highly suggestive of drug-induced liver injury. No other relevant drug exposure beside tocilizumab was recorded. She recovered totally after treatment discontinuation and an initial 3-day course of intravenous N-acetylcysteine with normalization of liver function tests after 6 weeks. Conclusion. Acute severe hepatitis can be associated with tocilizumab as documented in this case. Careful monitoring of liver function tests is warranted during tocilizumab treatment. |
| format | Article |
| id | doaj-art-cbd4af23babe4f9dbb70cf8b02665cac |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-cbd4af23babe4f9dbb70cf8b02665cac2025-02-03T01:20:37ZengWileyCase Reports in Hepatology2090-65872090-65952013-01-01201310.1155/2013/964828964828Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s DiseaseMichael Drepper0Laura Rubbia-Brandt1Laurent Spahr2Division of Gastroenterology and Hepatology, Department of Internal Medecine Specialties, Geneva University Hospital, Rue Gabrielle Perret Gentil 4, 1211 Geneva 14, SwitzerlandDivision of Clinical Pathology, Geneva University Hospital and Geneva Faculty of Medicine, Rue Gabrielle Perret Gentil 4, 1211 Geneva 14, SwitzerlandDivision of Gastroenterology and Hepatology, Department of Internal Medecine Specialties, Geneva University Hospital, Rue Gabrielle Perret Gentil 4, 1211 Geneva 14, SwitzerlandBackground. Tocilizumab, a monoclonal humanized anti-IL-6 receptor antibody, is used in treatment of refractory adult onset Still’s disease (AOSD). Mild to moderate liver enzyme elevation is a well-known side effect, but severe liver injury has only been reported in 3 cases in the literature. Case. A young female suffering from corticoid and methotrexate refractory AOSD was treated by tocilizumab. After 19 months of consecutive treatment, she developed acute severe liver injury. Liver biopsy showed extensive hepatocellular necrosis with ballooned hepatocytes, highly suggestive of drug-induced liver injury. No other relevant drug exposure beside tocilizumab was recorded. She recovered totally after treatment discontinuation and an initial 3-day course of intravenous N-acetylcysteine with normalization of liver function tests after 6 weeks. Conclusion. Acute severe hepatitis can be associated with tocilizumab as documented in this case. Careful monitoring of liver function tests is warranted during tocilizumab treatment.http://dx.doi.org/10.1155/2013/964828 |
| spellingShingle | Michael Drepper Laura Rubbia-Brandt Laurent Spahr Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease Case Reports in Hepatology |
| title | Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease |
| title_full | Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease |
| title_fullStr | Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease |
| title_full_unstemmed | Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease |
| title_short | Tocilizumab-Induced Acute Liver Injury in Adult Onset Still’s Disease |
| title_sort | tocilizumab induced acute liver injury in adult onset still s disease |
| url | http://dx.doi.org/10.1155/2013/964828 |
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