Subacute liver failure induced by adalimumab

Most cases of liver toxicity associated with TNF-antagonists have been linked to infliximab and to a lesser extent to etanercept. So far only mild elevations of liver enzymes during therapy with adalimumab have been reported. In general, patients who developed ALT and AST elevations were asymptomatic and the abnormalities decreased or resolved with either continuation or discontinuation of adalimumab, or modification of concomitant medications. In this case report, we are presenting the first case of a patient without previous history of liver disease or concomitant risk factors for liver disease who developed subacute liver failure during therapy with adalimumab for psoriatic arthritis.