Abstract
A 50-year-old woman was admitted to our hospital with complaints of loss of vision, diarrhea and arthralgia. She was given a diagnosis of Behçet disease and given infliximab (IFX) to halt the progression of acute vision loss. Liver damage was detected after the fourth IFX dose. We assumed that this was a drug-induced condition caused by salazosulfapyridine (SASP). However, the liver damage worsened, and the condition did not improve even after discontinuing SASP. Thus, therapy to enhance hepatic function was initiated. Histological analysis of liver biopsy specimens showed centrilobular spotty necrosis and periportal hepatitis. We diagnosed autoimmune hepatitis rather than drug-induced liver damage. Because of liver function deterioration, we initiated steroid treatment and rapid improvement was observed. Therefore, liver function should be carefully monitored during IFX administration for patients with genetic predispositions to autoimmune hepatitis, such as human leukocyte antigen-DR4.
