Bensaghir Imane, Tahiri Latifa, Farih Sara, Rkain Hanan, Allali Fadoua
Department of Rheumatology B, Ayachi Hospital, Ibn Sina Hospital Center, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR.
Department of Exercise Physiology and Autonomous Nervous System, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR.
Cureus. 2024 Aug 10;16(8):e66569. doi: 10.7759/cureus.66569. eCollection 2024 Aug.
Certolizumab-induced liver injury is exceptionally rare, with only a few cases reported in the literature. We present the case of a 34-year-old man with axial ankylosing spondylitis (AS) who developed a drug-induced liver injury following treatment with certolizumab. Despite the initial ineffectiveness of non-steroidal anti-inflammatory drugs and an inadequate response to infliximab, the patient achieved remission of AS symptoms with certolizumab. However, he subsequently developed elevated liver enzymes indicative of hepatocellular injury. Investigations excluded viral hepatitis and autoimmune liver diseases, pointing to certolizumab as the likely cause. The updated Roussel Uclaf Causality Assessment Method confirmed a probable causal relationship between certolizumab and hepatotoxicity. Discontinuation of certolizumab led to normalization of liver enzymes without recurrence of liver injury. This case highlights the need for vigilant monitoring for hepatotoxicity in patients receiving tumor necrosis factor inhibitors.
赛妥珠单抗引起的肝损伤极为罕见，文献中仅报道了少数病例。我们报告了一例34岁的轴向性强直性脊柱炎（AS）男性患者，在接受赛妥珠单抗治疗后发生了药物性肝损伤。尽管非甾体类抗炎药最初无效，且对英夫利昔单抗反应不佳，但该患者使用赛妥珠单抗后AS症状得到缓解。然而，他随后出现了提示肝细胞损伤的肝酶升高。检查排除了病毒性肝炎和自身免疫性肝病，表明赛妥珠单抗可能是病因。更新后的鲁塞尔·乌克拉夫因果关系评估方法证实赛妥珠单抗与肝毒性之间可能存在因果关系。停用赛妥珠单抗后肝酶恢复正常，且肝损伤未复发。该病例强调了对接受肿瘤坏死因子抑制剂治疗的患者进行肝毒性监测的必要性。
