英夫利昔单抗诱导的自身免疫性肝炎。
Infliximab-induced autoimmune hepatitis.
机构信息
Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
出版信息
BMJ Case Rep. 2021 May 24;14(5):e239944. doi: 10.1136/bcr-2020-239944.
Autoimmune hepatitis (AIH) is an inflammatory disorder of the liver with a wide spectrum of disease presentation, from asymptomatic elevations in liver-associated enzymes to acute liver failure. AIH is classically associated with elevated immunoglobulins and autoantibodies, although approximately 20% of patients with features of AIH lack circulating antibodies. Recently, tumour necrosis factor alpha inhibitors have been implicated in several cases of drug-induced AIH which impact treatment regimens for patients with inflammatory bowel disease (IBD). We present a case of infliximab-induced seronegative AIH responding to budesonide therapy with successful alteration of IBD treatment regimen to vedolizumab.
自身免疫性肝炎（AIH）是一种肝脏炎症性疾病，其临床表现广泛，从无症状的肝相关酶升高到急性肝衰竭。AIH 通常与免疫球蛋白和自身抗体升高有关，尽管大约 20%的具有 AIH 特征的患者缺乏循环抗体。最近，肿瘤坏死因子-α抑制剂已被牵涉到几例药物诱导的 AIH 中，这些病例影响了炎症性肠病（IBD）患者的治疗方案。我们报告了一例英夫利昔单抗诱导的血清阴性 AIH，对布地奈德治疗有反应，并成功地将 IBD 治疗方案改为维得利珠单抗。
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