Rare Hepatitis Complication in Infliximab Patient
Summary of Histoplasmosis Case Report
This article from Healio Gastroenterology details a rare case of histoplasmosis-associated necrotizing granulomatous hepatitis in a 62-year-old man with rheumatoid arthritis. Here’s a breakdown of the key facts:
* Patient: 62-year-old male with rheumatoid arthritis,previously treated with infliximab (a TNF-α inhibitor).
* Presentation: Hospitalized with abdominal pain, fever, tachycardia, and jaundice (icterus).
* Diagnosis: Initially investigated for biliary obstruction (ERCP with stent placement was performed), but ultimately diagnosed with Histoplasma capsulatum-associated necrotizing granulomatous hepatitis confirmed by liver biopsy.
* Treatment: Amphotericin B followed by 12 months of itraconazole.
* Key Takeaway: The physician (MD Rodrigues) emphasizes the importance of a high index of suspicion and early liver biopsy in diagnosing this rare complication, leading to a favorable outcome.
* Source: Presented at the ACG Annual Scientific Meeting (October 24-29, 2025, Phoenix).
* Disclosure: Dr. Rodrigues reports no relevant financial disclosures.
Significance: This case highlights the risk of opportunistic infections like histoplasmosis in patients taking TNF-α inhibitors like infliximab, and the importance of considering this possibility when patients present with unexplained liver disease.