scholarly journals Autoimmune hepatitis: Side effect of infliximab perfusion

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Kooli I ◽  
◽  
Guediche A ◽  
Harzallah G ◽  
Marrakchi W ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Side Effect ◽  
Undetectable Viral Load ◽  
Immunosuppressive Agent ◽  
Immunosuppressive Drugs ◽  
Level Control ◽  
Necrosis Factor Alpha ◽  
Serum Aspartate Aminotransferase ◽  
Factor Alpha ◽  
Living With Hiv

Background: Tumor necrosis factor-alpha (TNF-alpha), a basic cytokine is an immunosuppressive agent used intensively in the treatment of systemic diseases. various side effects have been reported with the use of these powerful immunosuppressive drugs. In this case we report an autoimmune hepatitis an uncommon side effect of infliximab perfusion. Case: A 41-year-old man living with HIV on emtricitabine tenofovir and efavirenz for 6 years with good tolerance and undetectable viral load had been diagnosed as having a Crohn disease. He was referred for persistent increase in aminotransferase levels during infliximab therapy. After the 3rd infusion, serum aspartate Aminotransferase (AST) and alanine Aminotransferase (ALT) raised to 75 and 136 IU/L. After exhaustive etiological exams we retained autoimmune hepatitis. Two months after stopping infliximab aminotransferases were normal. Conclusion: Infliximab induced autoimmune hepatitis is an uncommon side effect. Clinicians should be aware of this risk and should perform aminotransferase level control when infliximab use.

Effects of psoriasis treatment on genital warts: a case report

2019 ◽  
Vol 30 (8) ◽  
pp. 828-830 ◽  
Author(s):  
Marco Campoli ◽  
Elisa Cinotti ◽  
Michele Fimiani ◽  
Michele Pellegrino ◽  
Linda Tognetti ◽  
...  
Keyword(s):  
Cytotoxic T Lymphocyte ◽  
Clinical Manifestations ◽  
Genital Warts ◽  
Immunosuppressive Drugs ◽  
Additional Treatment ◽  
Cell Mediated Immunity ◽  
Complete Regression ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Factor Alpha

The use of immunosuppressive drugs predisposes to infections, as they block the most important stage in antiviral defense, which is the cytotoxic T-lymphocyte HLA-dependent response. We report a case of extensive genital warts in a young woman on therapy for psoriasis with cyclosporine, afterwards successfully treated with an anti-tumor necrosis factor alpha (TNF-α) agent. Cyclosporine may predispose to the reactivation of latent infections and may favor the clinical manifestations of human papillomavirus (HPV)-related diseases, due to the inhibition of cell-mediated immunity that plays a crucial role in controlling HPV infections. In the literature the relationship between HPV and TNF-blockers has not yet been clearly defined. Our case underlines that the prompt interruption of cyclosporine can induce a complete regression of warts without any additional treatment and adds evidence to the possible use of anti-TNF-α in patients with psoriasis and genital warts.

scholarly journals A rare complication in a Covid-19 positive patient with sigmoid colon cancer-hemoperitoneum due to gallbladder necrosis following micro-thrombosis

2021 ◽  
pp. 317-323
Author(s):  
Mihai Faur ◽  
Andrei Moisin ◽  
Calin Mohor ◽  
Dan Sabau
Keyword(s):  
Rare Complication ◽  
Interleukin 1 ◽  
Rapid Onset ◽  
Point Of View ◽  
Sigmoid Colon Cancer ◽  
Sensory Level ◽  
Level Control ◽  
Necrosis Factor Alpha ◽  
Factor Alpha ◽  
Viral Respiratory

Covid-19, also known as acute respiratory syndrome 2019-nCoV, severe acute respiratory syndrome (SARS) 2, and Wuhan pneumonia, is a viral respiratory disease caused by a SARS-associated coronavirus (SARS-CoV2). The most serious complications of Covid-19 are due to the development of micro-thrombosis in various organs and systems as a result of the high levels of pro-inflammatory cytokines (tumor necrosis factor alpha, interleukin 1 and 6) which initiate the activation of coagulation and the generation of thrombin. Several studies demonstrated the poor outcome of Covid-19-infected patients who underwent surgery, suggesting that surgery may accelerate and exacerbate Covid-19 progression. We report the case of an 81-year-old patient admitted as an emergency with Covid-19 pneumonia, hemoperitoneum, ischemic acute cholecystitis and obstructive sigmoid cancer. Cholecystectomy, pneumoperitoneal lavage, and Hartmann operation were performed under combined epidural-spinal anesthesia. This technique has some advantages compared to spinal and epidural techniques, such as: rapid onset of analgesia and the possibility of obtaining the desired sensory level, control of the anesthetic block, and ensuring postoperative analgesia. The unfavorable outcome of this case is due to the occurrence of the cytokine storm and coagulation disorders, with the change in the related biological constants, both from a biochemical and systemic point of view.

Vaccination in immunocompromised children

2013 ◽  
pp. 721-724
Author(s):  
Marloes Heijstek ◽  
Mario Abinun ◽  
Nico Wulffraat
Keyword(s):  
Disease Activity ◽  
Immunosuppressive Treatment ◽  
Immunosuppressive Drugs ◽  
High Dose ◽  
Necrosis Factor Alpha ◽  
Live Attenuated Vaccines ◽  
European League Against Rheumatism ◽  
Increased Risk ◽  
Immunosuppressed Patients ◽  
Factor Alpha

Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying antirheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. It is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals, but booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and tumour necrosis factor alpha (TNFα‎‎) may lower vaccine-induced antibody concentrations and may cause accelerated waning of immunity. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.

scholarly journals Biotherapies in Uveitis

2020 ◽  
Vol 9 (11) ◽  
pp. 3599
Author(s):  
Mathilde Leclercq ◽  
Anne-Claire Desbois ◽  
Fanny Domont ◽  
Georgina Maalouf ◽  
Sara Touhami ◽  
...  
Keyword(s):  
Therapeutic Strategy ◽  
Developed Countries ◽  
Immunosuppressive Drugs ◽  
First Line ◽  
Necrosis Factor Alpha ◽  
First Line Therapy ◽  
Tnf Α ◽  
Infectious Uveitis ◽  
Factor Alpha ◽  
Necrosis Factor

Non-infectious uveitis (NIU) represents one of the leading causes of blindness in developed countries. The therapeutic strategy aims to rapidly control intra-ocular inflammation, prevent irremediable ocular damage, allow corticosteroid sparing and save the vision, and has evolved over the last few years. Anterior NIU is mostly managed with topical treatment in adults. However, for intermediate, posterior and pan-uveitis, notably when both eyes are involved, systemic treatment is usually warranted. Biotherapies are recommended in case of inefficacy or non-tolerance of conventional immunosuppressive drugs in non-anterior NIU. Anti-tumor necrosis factor alpha (anti-TNF-α) agents are by far the most widely used, especially adalimumab (ADA) and infliximab (IFX). In case of sight-threatening uveitis in Behçet’s disease or in case of risk of severe recurrences, respectively IFX and ADA may be recommended as first-line therapy. Many questions are left unanswered; how long to treat NIU, how to discontinue anti-TNF-α agents, what biologic to use in case of anti-TNF-α failure? The objective of this review is to present an updated overview of knowledge on the use of biological treatments in NIU.

Infliximab-induced autoimmune hepatitis

2021 ◽  
Vol 14 (5) ◽  
pp. e239944
Author(s):  
Alexander Jenkins ◽  
Amy Austin ◽  
Kathryn Hughes ◽  
Brett Sadowski ◽  
Dawn Torres
Keyword(s):  
Autoimmune Hepatitis ◽  
Wide Spectrum ◽  
Inflammatory Disorder ◽  
Drug Induced ◽  
Necrosis Factor Alpha ◽  
Treatment Regimens ◽  
Circulating Antibodies ◽  
Inflammatory Bowel ◽  
Factor Alpha ◽  
Necrosis Factor

Autoimmune hepatitis (AIH) is an inflammatory disorder of the liver with a wide spectrum of disease presentation, from asymptomatic elevations in liver-associated enzymes to acute liver failure. AIH is classically associated with elevated immunoglobulins and autoantibodies, although approximately 20% of patients with features of AIH lack circulating antibodies. Recently, tumour necrosis factor alpha inhibitors have been implicated in several cases of drug-induced AIH which impact treatment regimens for patients with inflammatory bowel disease (IBD). We present a case of infliximab-induced seronegative AIH responding to budesonide therapy with successful alteration of IBD treatment regimen to vedolizumab.

Vaccination in immunocompromised children

2016 ◽  
Author(s):  
Marloes Heijstek ◽  
Mario Abinun ◽  
Nico Wulffraat
Keyword(s):  
Disease Activity ◽  
Immunosuppressive Treatment ◽  
Immunosuppressive Drugs ◽  
High Dose ◽  
Necrosis Factor Alpha ◽  
Live Attenuated Vaccines ◽  
European League Against Rheumatism ◽  
Increased Risk ◽  
Immunosuppressed Patients ◽  
Factor Alpha

Can immunocompromised children be safely and effectively vaccinated? This chapter discusses the recommendations from the European League Against Rheumatism (EULAR) for the immunization of immunocompromised patients. Patients with rheumatic or autoinflammatory diseases treated with high-dose glucocorticoids, high-dose disease-modifying antirheumatic drugs (DMARDs), or biologicals are considered immunocompromised. Safe and effective vaccination is crucial in these patients, given their increased risk of infection. Safe vaccination implies that vaccination has no effect on disease activity and has only mild adverse effects. Effective vaccination denotes that patients are protected against infections after immunization. Particularly in severely immunosuppressed patients, concerns arise on the safety of (live-attenuated) vaccines and on the detrimental effect of immunosuppressive treatment on the immunogenicity of vaccines. Overall, vaccinations do not increase disease activity and do not cause severe adverse events. It is recommended to withhold live-attenuated vaccines in patients on high-dose immunosuppressive drugs and biologicals, but booster vaccinations can be considered when essential. Generally, immunogenicity of vaccines is good with some exceptions: responses are reduced in patients on high-dose glucocorticoids and rituximab; methotrexate reduces responses to (pneumococcal) polysaccharide vaccines; and tumour necrosis factor alpha (TNFα‎) may lower vaccine-induced antibody concentrations and may cause accelerated waning of immunity. Offering vaccination before immunosuppressive drugs and/or measuring antibodies after immunization is recommended.

New Onset Autoimmune Hepatitis during Anti-Tumor Necrosis Factor-Alpha Treatment in Children

2018 ◽  
Vol 194 ◽  
pp. 128-135.e1 ◽  
Author(s):  
Amanda Ricciuto ◽  
Binita M. Kamath ◽  
Thomas D. Walters ◽  
Karen Frost ◽  
Nicholas Carman ◽  
...  
Keyword(s):  
Tumor Necrosis Factor ◽  
Autoimmune Hepatitis ◽  
Tumor Necrosis Factor Alpha ◽  
Tumor Necrosis ◽  
Necrosis Factor Alpha ◽  
Factor Alpha ◽  
Necrosis Factor ◽  
New Onset
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