Abstract
A 73-year-old female, who suffered from rheumatoid arthritis for 10 years, developed precore mutant hepatitis B virus-associated fulminant hepatitis after 1 year of infliximab therapy and subsequent methotrexate withdrawal. We emphasize the importance of preemptive antiviral therapy before starting infliximab administration and withdrawing immunosuppressive drugs.
MeSH terms
-
Aged
-
Antibodies, Monoclonal / adverse effects*
-
Antirheumatic Agents / adverse effects*
-
Arthritis, Rheumatoid / immunology
-
Arthritis, Rheumatoid / pathology
-
Arthritis, Rheumatoid / virology*
-
DNA, Viral / analysis
-
Drug Therapy, Combination
-
Fatal Outcome
-
Female
-
Hepatitis B / complications*
-
Hepatitis B / immunology
-
Hepatitis B / pathology
-
Hepatitis B Core Antigens / blood
-
Hepatitis B Core Antigens / immunology
-
Hepatitis B virus / genetics*
-
Hepatitis B virus / immunology
-
Humans
-
Immunosuppressive Agents / therapeutic use
-
Infliximab
-
Methotrexate / therapeutic use
-
Mutation*
-
Withholding Treatment
Substances
-
Antibodies, Monoclonal
-
Antirheumatic Agents
-
DNA, Viral
-
Hepatitis B Core Antigens
-
Immunosuppressive Agents
-
Infliximab
-
Methotrexate