Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2015; 21(24): 7584-7588
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7584
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7584
Autoimmune hepatitis and anti-tumor necrosis factor alpha therapy: A single center report of 8 cases
Susana Rodrigues, Susana Lopes, Fernando Magro, Hélder Cardoso, Ana Maria Horta e Vale, Margarida Marques, Guilherme Macedo, Department of Gastroenterology, Centro Hospitalar de São João, 4200-319 Porto, Portugal
Eva Mariz, Miguel Bernardes, Department of Rheumatology, Centro Hospitalar de São João, 4200-319 Porto, Portugal
Joanne Lopes, Fátima Carneiro, Department of Pathology, Centro Hospitalar de São João, 4200-319 Porto, Portugal
Fátima Carneiro, Institute of Molecular Pathology and Immunology at the University of Porto, 4200-319 Porto, Portugal
Author contributions: Rodrigues S study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; Lopes S analysis and interpretation of data; critical revision of the manuscript for important intellectual content; Magro F study concept and design; analysis and interpretation of data; critical revision of the manuscript for important intellectual content; Cardoso H, Horta e Vale AM, Marques M, Mariz E, Bernardes M and Lopes J analysis and interpretation of data; Carneiro F and Macedo G critical revision of the manuscript for important intellectual content.
Ethics approval: This manuscript is of a case series and not a formal study with a protocol, therefore no submission was made to the Hospital Ethics Review Board.
Informed consent: I hereby declare that all the patients included in the case series were aware that the cases were being submitted for publication in a scientific journal and consented.
Conflict-of-interest: None of the authors of this manuscript have any conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guilherme Macedo, MD, PhD, Department of Gastroenterology, Centro Hospitalar de São João, 4200-319 Porto, Portugal. guilhermemacedo59@gmail.com
Telephone: +351-225-512100 Fax: +351-225-025766
Received: October 6, 2014
Peer-review started: October 6, 2014
First decision: October 29, 2014
Revised: November 24, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: June 28, 2015
Processing time: 266 Days and 14 Hours
Peer-review started: October 6, 2014
First decision: October 29, 2014
Revised: November 24, 2014
Accepted: January 30, 2015
Article in press: January 30, 2015
Published online: June 28, 2015
Processing time: 266 Days and 14 Hours
Core Tip
Core tip: A total of 8 patients with anti-tumor necrosis factor (TNF)-α-induced autoimmune hepatitis were detected in a single center with over 600 patients. The authors raise the question as to whether most cases represent autoimmune-like drug-induced liver injury (DILI) or defined autoimmune hepatitis (AIH) as the majority of patients responded favorably to steroids and did not require maintenance therapy corresponding to the former. Although anti-TNF therapy-related AIH is rare, a baseline immunological panel along with liver function tests should be performed in all patients with autoimmune disease before starting biologics, in order to detect undiagnosed AIH or help differentiate between DILI and established AIH.