Reactivation of hepatitis B in a patient with spondyloarthritis after the suspension of methotrexate and efficacy of treatment with antivirals in association to adalimumab

Cobeta García, Juan Carlos; Medrano, Marta

doi:10.1016/S2173-5743(11)70041-7

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Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reactivación de hepatitis B en un paciente con espondiloartritis tras suspender metotrexato y eficacia del tratamiento con antivirales en asociación con adalimumab" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-05-01" "fechaAceptado" => "2010-08-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112749" "palabras" => array:5 [ 0 => "Hepatitis B virus" 1 => "Spondyloarthritis" 2 => "Methotrexate" 3 => "Anti-TNF" 4 => "Antivirals" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112750" "palabras" => array:5 [ 0 => "Virus hepatitis B" 1 => "Espondiloartritis" 2 => "Metotrexato" 3 => "Anti-TNF" 4 => "Antivirales" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "We report the case of a male chronic hepatitis B virus (HBV) carrier with HLA-B27 spondyloarthrititis who developed fulminant hepatitis after discontinuation of methotrexate (MTX). Full recovery after therapy with lamivudine and adefovir allowed treatment with adalimumab which was well tolerated.Reactivation of hepatitis B after MTX withdrawal is a very rare complication, which can also occur in association with anti-TNF agents. In patients with positive serology for HBV prophylactic antiviral therapy is recommended." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Comunicamos el caso de un varón portador crónico de virus de hepatitis B (VHB) con espondiloartritis B27 positivo que desarrolló una hepatitis fulminante tras la suspensión del tratamiento con metotrexato (MTX). Una total recuperación tras terapia con lamivudina y adefovir permitió un tratamiento con adalimumab sin otras complicaciones y buena tolerancia.La reactivación de hepatitis B tras suspensión de MTX es una complicación muy poco frecuente, que también puede ocurrir con los anti-TNF. En pacientes con serología positiva de VHB se recomienda tratamiento profiláctico con antivirales." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Lalazar" 1 => "D. Rund" 2 => "D. 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Article information

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Abstract

We report the case of a male chronic hepatitis B virus (HBV) carrier with HLA-B27 spondyloarthrititis who developed fulminant hepatitis after discontinuation of methotrexate (MTX). Full recovery after therapy with lamivudine and adefovir allowed treatment with adalimumab which was well tolerated.

Reactivation of hepatitis B after MTX withdrawal is a very rare complication, which can also occur in association with anti-TNF agents. In patients with positive serology for HBV prophylactic antiviral therapy is recommended.

Keywords:

Hepatitis B virus

Spondyloarthritis

Methotrexate

Anti-TNF

Antivirals

Resumen

Comunicamos el caso de un varón portador crónico de virus de hepatitis B (VHB) con espondiloartritis B27 positivo que desarrolló una hepatitis fulminante tras la suspensión del tratamiento con metotrexato (MTX). Una total recuperación tras terapia con lamivudina y adefovir permitió un tratamiento con adalimumab sin otras complicaciones y buena tolerancia.

La reactivación de hepatitis B tras suspensión de MTX es una complicación muy poco frecuente, que también puede ocurrir con los anti-TNF. En pacientes con serología positiva de VHB se recomienda tratamiento profiláctico con antivirales.

Palabras clave:

Virus hepatitis B

Espondiloartritis

Metotrexato

Anti-TNF

Antivirales

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References

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G. Lalazar, D. Rund, D. Shouval.

Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies.

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http://dx.doi.org/10.1111/j.1365-2141.2006.06465.x | Medline

[2.]

M.A. Flowers, J. Heathcote, I.R. Wanless, M. Sherman, W.J. Reynolds, R.G. Cameron, et al.

Fulminant hepatitis as a consequence of reactivation of Hepatitis B virus infection after discontinuation of low-dose methotrexate therapy.

Ann Intern Med, 112 (1990), pp. 381-382

Article | Medline

[3.]

J. Narváez, J. Rodríguez-Moreno, M.D. Martínez-Aguilá, M.T. Clavaguera.

Severe hepatitis linked to B Virus infection after withdrawal of low dose methotrexate therapy.

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