Certolizumab-associated autoimmune-like hepatitis.

Area of Science:

• Hepatology
• Immunology
• Dermatology

Background:

• Tumour necrosis factor alpha (TNF-α) inhibitors are used for autoimmune diseases like psoriasis.
• Liver injury has been reported with infliximab and adalimumab, other TNF-α inhibitors.

Purpose of the Study:

• To report a case of drug-induced liver injury (DILI) associated with certolizumab in a patient with psoriasis.
• To highlight the potential for autoimmune-like hepatitis across the TNF-α inhibitor class.

Main Methods:

• A case report of a woman in her early 30s treated with certolizumab for psoriasis.
• Inclusion of liver function tests, liver screening, and liver biopsy.
• Monitoring of liver function post-drug discontinuation.

Main Results:

• The patient developed acute severe hepatitis, indicative of DILI secondary to certolizumab.
• Histological examination confirmed acute severe hepatitis.
• Liver function tests normalized after discontinuing certolizumab, with stable follow-up.

Conclusions:

• Drug-induced autoimmune-like hepatitis is a potential adverse effect associated with the TNF-α inhibitor class.
• Clinicians should consider DILI when initiating or managing patients on TNF-α inhibitors for psoriasis or other autoimmune conditions.