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

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

Volume: 13 Issue: 3

Author(s): Rosa Lovero, Giuseppe Losurdo, Marcella Mastromauro, Nicola Maurizio Castellaneta, Antonio Mongelli, Antonietta Gentile, Alfredo Di Leo and Mariabeatrice Principi*

Affiliation:

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

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

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.

Cite this article as:

Lovero Rosa , Losurdo Giuseppe , Mastromauro Marcella , Castellaneta Maurizio Nicola , Mongelli Antonio , Gentile Antonietta , Di Leo Alfredo and Principi Mariabeatrice *, A Case of Severe Transaminase Elevation Following a Single Ustekinumab Dose with Remission After Drug Withdrawal, Current Drug Safety 2018; 13 (3) . https://dx.doi.org/10.2174/1574886313666180719165212