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Hepatitis and pneumonitis during adalimumab therapy in Crohn disease: mind the histoplasmosis!

Arq Gastroenterol

November 2014

Divisão de Gastroenterologia, Departamento de Medicina, Centro de Doenças Inflamatórias Intestinais, Hospital da Universidade Federal de Juiz de Fora>, Juiz de Fora, MG, Brasil.

Context: Tumor necrosis factor-alpha (TNF-α) inhibitor therapy plays a pivotal role in the management of moderate to severe inflammatory bowel disease. Because of the role of TNF-α in the host defenses, anti-TNF therapy has been associated with an increase the risks of granulomatous infections.

Objective: To report the first case of adalimumab-associated invasive histoplasmosis presenting as an acute hepatitis-like syndrome and febrile pneumonitis in a patient with Crohn's disease.

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