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BMJ Case Reports 2009; doi:10.1136/bcr.09.2008.0873
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Deterioration of the liver biochemistry due to reactivation of chronic hepatitis B during etanercept treatment for rheumatoid arthritis

  1. Shu-Chen Kuo1,
  2. Hui-Ting Lee1,
  3. Wei-Sheng Chen1,
  4. Chung-Tei Chou1,
  5. Chang-Youh Tsai1,2
  1. 1
    Taipei Veterans General Hospital, Division of Allergy, Immunology & Rheumatology, 201 Shih-Pai Road Section 2, Taipei, 112, Taiwan, Province of China
  2. 2
    National Yang-Ming University, Faculty of Medicine, 155 Li-Nong Street, Taipei, 112, Taiwan, Province of China
  1. Chang-Youh Tsai, cytsai{at}vghtpe.gov.tw
  • Published 17 March 2009

Summary

To report a hepatitis B virus (HBV) reactivation during the treatment of etanercept for rheumatoid arthritis (RA).

The chronological course of a patient with RA who developed HBV reactivation associated with etanercept treatment was recorded.

A Taiwanese woman with RA was treated by etanercept. A severe deterioration of liver biochemistry occurred soon after the start of the biologicals because of the previously unrecognised HBV carrier status. The condition was successfully alleviated by oral lamivudine administration.

In the prevalent area of HBV, viral titre monitoring and pre-emptive antiviral treatment may be fundamentally important to avoid serious complications of HBV reactivation whenever a new treatment modality such as biologicals is started for patients with RA.

Footnotes

  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.

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