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Case Reports
. 2019 Jul 3:12:1179547619858979.
doi: 10.1177/1179547619858979. eCollection 2019.

Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn's Disease: A Case Report

Kanika Goel  1 , Mark Bunker  1 , Anna Balog  1 , Jan F Silverman  1
Affiliations
Case Reports

Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn's Disease: A Case Report

Kanika Goel et al. Clin Med Insights Case Rep. .

Abstract

Herpes simplex virus (HSV) hepatitis is an uncommon cause of fulminant hepatic failure, seen mostly in immunocompromised patients. Conventional treatment modalities for inflammatory bowel disease (IBD), such as steroids and azathioprine, have been known to cause HSV hepatitis. However, the reported incidence of HSV hepatitis in IBD patients undergoing tumor necrosis factor (TNF)-α inhibitor therapy is very rare. In this case report, we describe a rare case of fulminant HSV hepatitis that developed in a patient with Crohn's disease after treatment with the TNF-α inhibitor, adalimumab.

Keywords: Crohn’s disease; TNF-α inhibitor; adalimumab; hepatitis; herpes simplex virus; inflammatory bowel disease.

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Conflict of interest statement

Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Postmortem histological section from liver showing confluent massive necrosis with minimal inflammation (A). At higher power, large ground-glass nuclei are seen (B).
Figure 2.
Figure 2.
Strong and diffusely positive immunohistochemical staining for HSV in liver.
Figure 3.
Figure 3.
Focal necrosis (A), with patchy HSV–immunohistochemical positivity (B) in the spleen.
See this image and copyright information in PMC

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