1. Hepatitis E during Tocilizumab Therapy in a Patient with Rheumatoid Arthritis: Case Report and Literature Review
- Author
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Akito Maeshima, Masao Nakasatomi, Yoshihisa Nojima, Kana Koinuma, Keiju Hiromura, Toshihide Mimura, Yoriaki Kaneko, Toru Sakairi, Hiroaki Okamoto, Yuichi Yamazaki, Satoshi Mochida, and Hidekazu Ikeuchi
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,viruses ,Case Report ,Disease ,medicine.disease_cause ,Gastroenterology ,Tocilizumab therapy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Hepatitis E virus ,Internal medicine ,medicine ,skin and connective tissue diseases ,030203 arthritis & rheumatology ,Hepatitis ,business.industry ,virus diseases ,General Medicine ,Hepatitis E ,medicine.disease ,chemistry ,Rheumatoid arthritis ,030211 gastroenterology & hepatology ,Liver function ,lcsh:RC925-935 ,business - Abstract
Hepatitis E is an acute self-limiting disease caused by hepatitis E virus (HEV). Recent reports show that HEV can induce chronic hepatitis or be reactivated in immunocompromised hosts. We report a 63-year-old woman with rheumatoid arthritis (RA) who developed hepatitis E during treatment with tocilizumab. Analysis of serially stocked serum samples confirmed that hepatitis was caused by primary infection with HEV and not by viral reactivation. Her liver function improved after discontinuing tocilizumab and remained within the normal range without reactivation of HEV for >5 years after restarting tocilizumab. We also reviewed the published cases of hepatitis E that developed during RA treatment.
- Published
- 2018