A case report: Ulcerative colitis, treatment with an antibody against tumor necrosis factor (infliximab), and subsequent liver necrosis

In recent years, the use of antibodies against tumor necrosis factor alpha (TNF alpha) has expanded in rheumatology, gastroenterology, and dermatology. In addition to the more common side effects such as infections and hypersensitivity reactions, elevations of liver enzymes have been reported during anti-TNF alpha therapy, although severe liver failure has been extremely uncommon. This report describes a patient with severe liver failure after induction therapy with the TNF alpha antibody infliximab (Remicade (R)). A 46-year old female patient received two infusions of infliximab at a dose of 400 mg on weeks 0 and 8 for steroid-dependent ulcerative colitis. Eight weeks after the second infusion, she suffered acute liver failure with necrosis, requiring liver transplantation. (C) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.