Severe hepatic toxicity after administration of infliximab in psoriasis treatment

Abstract

The true incidence of drug-induced liver injury (DILI) is difficult to discern because of an unknown denominator of individuals receiving a drug, lack of a simple objective test for the diagnosis of DILI, lack of consensus on what liver test abnormalities constitute DILI, difficulty in attribution of causation to a single drug in those on many medicines, and lack of systematic reporting. Over 1000 medications and herbal products have been involved in causing liver injury, and the list continues to grow. Regarding the biologic therapy with infliximab, according to specialized studies, usually there were mild to moderate elevations of liver enzymes. Hereby, we present a clinical case of drug-induced hepatitis, after the administration of monoclonal antibodies over six months, with a remarkable contrast between the major biochemical changes and the absence of any symptoms.