Article Text

Novel treatment (new drug/intervention; established drug/procedure in new situation)
The use of infliximab in a patient with idiopathic granulomatous hepatitis
  1. Sabrina Reenu Kapoor,
  2. Neil Snowden
  1. North Manchester General, Rheumatology, Delaunays Road, Crumpsall, Manchester M8 5RB, UK
  1. Neil Snowden, Neil.snowden{at}


We report a therapeutic response to infliximab in a patient with idiopathic granulomatous hepatitis resistant to treatment with methotrexate and corticosteroids. A 41-year-old woman presented with a 12-month history of fever, night sweat, gross hepatomegaly and 13 kg weight loss. Infection and malignancy were carefully excluded and a liver biopsy showed changes consistent with idiopathic granulomatous hepatitis. The patient was treated with high dose steroids and methotrexate, but her clinical symptoms and biochemical and radiological signs did not settle. Introduction of infliximab led to rapid and sustained resolution of symptoms, hepatomegaly and liver function tests (LFTs) after 1 year of follow-up. To our knowledge this is the first successful use of infliximab in idiopathic granulomatous hepatitis.

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  • Competing interests: none.

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

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