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World J Hepatol. Oct 27, 2013; 5(10): 592-595
Published online Oct 27, 2013. doi: 10.4254/wjh.v5.i10.592
Published online Oct 27, 2013. doi: 10.4254/wjh.v5.i10.592
Severe cholestasis due to adalimumab in a Crohn’s disease patient
Edward Kim, Brian Bressler, Eric M Yoshida, Division of Gastroenterology, University of British Columbia, Vancouver, Vancouver, BC V5Z 1M9, Canada
David F Schaeffer, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
Author contributions: Kim E drafted the manuscript and made the suggested revisions; Yoshida EM provided patient details for the case presentation, assisted in drafting the manuscript, reviewed the manuscript and made suggestions on revisions, and assisted with journal submission; Schaeffer DF and Bressler B reviewed the manuscript and made suggestions on revisions, and provided the pathology slides and comments.
Correspondence to: Eric M Yoshida, MD, Professor of Medicine, Head, Division of Gastroenterology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada. eric.yoshida.@vch.ca
Telephone: +1-604-8755244 Fax: +1-604-8755447
Received: June 6, 2013
Revised: September 20, 2013
Accepted: October 16, 2013
Published online: October 27, 2013
Processing time: 142 Days and 20.9 Hours
Revised: September 20, 2013
Accepted: October 16, 2013
Published online: October 27, 2013
Processing time: 142 Days and 20.9 Hours
Core Tip
Core tip: Anti-tumor necrosis factor agents are commonly used in the treatment of inflammatory bowel disease and other inflammatory conditions. Drug-induced injury to the liver induced by the agents includes autoimmune hepatitis, direct hepatocellular necrosis and cholestasis. Our patient, a 39-year-old female with Crohn’s disease, developed severe jaundice after initiation of adalimumab. We present the first report of adalimumab-associated severe cholestatic injury and the first histopathologic examination of this adverse drug effect. Clinicians need to be aware of this potential severe drug-induced liver injury when prescribing this commonly used biologic medication.