Etanercept
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Etanercept Neutropenia, thrombocytopenia and granulomatous hepatitis: case report A 17-year-old girl with erosive rheumatoid arthritis developed neutropenia and thrombocytopenia during treatment with etanercept; following reintroduction of etanercept, she developed granulomatous hepatitis. In May 2004, the girl started receiving SC etanercept 25mg twice weekly and, in June 2005, laboratory tests revealed a haemoglobin level of 135 g/L, a WBC count of 4.0 × 109/L, a platelet count of 139 × 109/L and a neutrophil count of 0.8 × 109/L. Etanercept was discontinued and the girl’s neutrophil and platelet counts returned to normal. In late July 2005, she experienced an arthritis flare and etanercept was reintroduced at a dosage of 25mg weekly. In November 2005, laboratory tests revealed an ALP level of 267 U/L, an ALT level of 162 U/L, an AST level of 72 U/L and a γglutamyl transferase level of 302 U/L. In January 2006, these abnormalities were still present and etanercept was discontinued. In May 2006, a liver biopsy revealed granulomatous hepatitis with expanded portal tracts and an infiltrate of mixed chronic inflammatory cells and occasional bile ductular damage. Both her portal tracts and hepatic parenchyma contained noncaseating granulomata. In May 2007, repeat blood tests revealed the following levels: ALP 193 U/L, ALT 57 U/L, AST 46 U/L and γ-glutamyl transferase 62 U/L. Farah M, et al. Granulomatous hepatitis associated with etanercept therapy. The 801105044 Journal of Rheumatology 35: 349-351, No. 2, Feb 2008 - Canada
0114-9954/10/1194-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 22 Mar 2008 No. 1194
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