Case Report

Granulomatous Hepatitis Associated with Etanercept Therapy

MYRIAM FARAH, ABDULRAHMAN AL RASHIDI, DAVID A. OWEN, ERIC M. YOSHIDA, and GRAHAM D. REID

ABSTRACT.

Etanercept has recently been implicated in the induction of granulomatous reactions. We describe a patient with rheumatoid arthritis who developed granulomatous hepatitis after taking etanercept. Infectious and metabolic causes of liver disease had been excluded and the liver biopsy was not typical of sarcoidosis. Liver enzyme abnormalities improved after etanercept was discontinued. We suggest that etanercept was responsible for the development of granulomatous hepatitis. This has not been previously described and adds to the increasing reports of rare granulomatous reactions induced by etanercept therapy. (J Rheumatol 2008;35:349-51)

Key Indexing Terms:

ETANERCEPT
GRANULOMATOUS
HEPATITIS
RHEUMATOID ARTHRITIS

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From the Departments of Medicine, Rheumatology, Pathology, and Gastroenterology, University of British Columbia, Vancouver, BC, Canada.

M. Farah, MD; A. Al Rashidi, MD; D.A. Owen, MB, ChB, Professor, Department of Pathology and Laboratory Medicine; E.M. Yoshida, MD, Associate Professor, Department of Gastroenterology; G.D. Reid, MB, ChB, Clinical Assistant Professor, Department of Rheumatology, University of British Columbia.

Address reprint requests to Dr. G.D. Reid, #306 – 888 West 8th Ave., Vancouver, BC V5Z 3Y1, Canada.

Accepted for publication September 28, 2007.

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