Severe hepatic toxicity after administration of infliximab in psoriasis treatment

Oana Gabriela Chiriac, Anca Trifan, Ana Maria Singeap, Camelia Cojocariu, Carol Stanciu, Catalin Sfarti


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.


biologic therapy, infliximab, psoriasis, liver injury, DILI

Full Text:



Abboud G, Kaplowitz N. Drug-induced liver injury. Drug Saf 2007; 30:277–294.

Leise MD, Poterucha JJ, Talwalkar JA. Drug induced liver injury. Mayo Clinic proceedings. 2014; 89(1):95-106.

Tajiri K, Shimizu Y. Practical guidelines for diagnosis and early management of drug induced liver injury. World J Gastroenterol 2008; 14(44):6774-85.

Ghabril M, Bonkovsky HL, Kum C, et al. Liver injury from tumor necrosis factor-alpha antagonists: analysis of thirty-four cases. Clin Gastroenterol Hepatol 2013; 11(5):558–564.

Grant LM, Rockey DC. Drug induced liver injury. Curr Opin Gastroenterol 2012; 28(3):198-202.

Lammert C, Bjornsson E, Niklasson A, Chalasani N. Oral medications with significant hepatic metabolism at higher risk for hepatic adverse events. Hepatology 2010; 51(2):615-20.

Chalasani N, Fontana RJ, Bonkovsky HL, et al. Causes, clinical features, and outcomes from a prospective study of drug induced liver injury in the United States. Gastroenterology 2008; 135(6):1924-34.

Uetrecht J. Idiosyncratic drug reactions: past, present and future. Chem Res Toxicol 2008; 21(1):84-92.

Liss G, Rattan S, Lewis JH. Predicting and preventing acute liver injury. What’s new in 2010? Expert Opin Drug Metab Toxicol 2010; 6(9):1047- 61.

Bernal, Auzinger G, Dhawan A, Wendon J. Acute liver failure. Lancet 2010; 376(9736):190-201.


Copyright (c)

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


ISSN: 2360-6975