Submit Manuscript  

Article Details


A Case of Severe Transaminase Elevation Following a Single Ustekinumab Dose with Remission After Drug Withdrawal

[ Vol. 13 , Issue. 3 ]

Author(s):

Rosa Lovero, Giuseppe Losurdo, Marcella Mastromauro, Nicola Maurizio Castellaneta, Antonio Mongelli, Antonietta Gentile, Alfredo Di Leo and Mariabeatrice Principi*   Pages 221 - 223 ( 3 )

Abstract:


Background: Ustekinumab is a fully human monoclonal antibody which binds Interleukin (IL)-12/23. It is indicated for the treatment of moderate-severe psoriasis and active psoriatic arthritis. Few data are available about the possibility of an interaction between ustekinumab and the liver.

Case Description: We reported a case of a 61-year old woman admitted to our Unit for severe transaminase elevation (aspartate transaminase 756 IU/l, alanine transaminase 1212 IU/l) occurred after a single Ustekinumab infusion for psoriasis. All other possible causes of liver damage, including drugs, hepatitis viruses, auto-antibodies and metabolic disorders were excluded. Liver biopsy showed lymphocytic infiltration, biliary duct damage and piecemeal necrosis. On the bases of the nonspecific histological picture and Rucam score, we accomplished the diagnosis of “liver injury of iatrogenic origin”. After drug withdrawal, a spontaneous normalization of liver enzymes occurred within six months.

Keywords:

Ustekinumab, drug-induced liver injury, transaminase elevation, liver, adverse events, HBV, HCV.

Affiliation:

Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Pathology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Pathology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari, Section of Gastroenterology, Department of Emergency and Organ Transplantation, AOU Policlinico, University of Bari, Bari

Graphical Abstract:



Read Full-Text article