Infliximab-induced autoimmune-like hepatitis in a patient with Crohn's disease: a case report

As medical treatments advance, drug-induced liver injury (DILI) becomes more prevalent, occurring at a rate of 14 to 19 cases per 100,000 individuals. We present a unique case of a female patient with Crohn's disease developing autoimmune-like hepatitis during infliximab treatment. Autoimmune-like hepatitis can pose diagnostic challenges when distinguishing it from idiopathic autoimmune hepatitis. The diagnostic journey, including the absence of distinct pathognomonic criteria, is discussed. The only discriminative factor observed was the absence of relapse in autoimmune-like hepatitis patients after discontinuation of immuno-suppressive therapy. The case highlights the importance of recognizing this adverse event in clinical practice and underscores the challenges in balancing the benefits and risks of powerful immunomodulatory agents.