Precore mutant hepatitis B virus-associated fulminant hepatitis during infliximab therapy for rheumatoid arthritis

Clin Rheumatol. 2013 Mar;32 Suppl 1(Suppl 1):S47-9. doi: 10.1007/s10067-010-1438-y. Epub 2010 Apr 9.

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.

Publication types

  • Case Reports

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