Certolizumab関連自己免疫様肝炎
Eleanor Peggie1, Sashrika Shetty2, Michael Johnston2
1Gastroenterology, Queen Elizabeth University Hospital, Glasgow, UK eleanor.peggie@nhs.scot.
BMJ case reports
|December 21, 2025
まとめ
腫瘍壊死因子α(TNF-α)阻害薬は肝障害を引き起こす可能性がある。この症例報告では、乾癬患者におけるTNF-α阻害薬であるセルトリズマブによる薬剤誘発性自己免疫様肝炎について詳述し、クラス全体のリスクを強調している。
科学分野:
- 肝臓病学
- 免疫学
- 皮膚科学
背景:
- 腫瘍壊死因子α(TNF-α)阻害薬は、乾癬などの自己免疫疾患に使用される。
- 肝障害は、他のTNF-α阻害薬であるインフリキシマブおよびアダリムマブでも報告されている。
研究 の 目的:
- 乾癬患者におけるセルトリズマブ関連の薬剤誘発性肝障害(DILI)の症例を報告する。
- TNF-α阻害薬クラス全体における自己免疫様肝炎の可能性を強調する。
主な方法:
- 乾癬の治療でセルトリズマブを投与された30代前半の女性の症例報告。
- 肝機能検査、肝臓スクリーニング、肝生検の実施。
- 薬剤中止後の肝機能モニタリング。
主要な成果:
- セルトリズマブによるDILI(薬剤誘発性肝障害)を示唆する急性重症肝炎を発症した。
- 組織学的検査により急性重症肝炎を確認した。
- セルトリズマブ中止後、肝機能検査値は正常化し、経過は安定していた。
結論:
- 薬剤誘発性自己免疫様肝炎は、TNF-α阻害薬クラスに関連する潜在的な有害作用である。
- 乾癬またはその他の自己免疫疾患の治療でTNF-α阻害薬の投与を開始または管理する際には、DILIを考慮する必要がある。
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