Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review
Hepatocellular carcinoma most commonly occurs in patients with underlying liver disease or cirrhosis. We describe a case of hepatocellular carcinoma in a 34-year-old man with Crohn’s disease treated with azathioprine and infliximab. The patient had no history of liver disease and a complete autoimmu...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2014-01-01
|
| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/340836 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558707548880896 |
|---|---|
| author | Kyle J. Fortinsky Ali Alali Khursheed Jeejeebhoy Sandra Fischer Morris Sherman Scott Fung |
| author_facet | Kyle J. Fortinsky Ali Alali Khursheed Jeejeebhoy Sandra Fischer Morris Sherman Scott Fung |
| author_sort | Kyle J. Fortinsky |
| collection | DOAJ |
| description | Hepatocellular carcinoma most commonly occurs in patients with underlying liver disease or cirrhosis. We describe a case of hepatocellular carcinoma in a 34-year-old man with Crohn’s disease treated with azathioprine and infliximab. The patient had no history of liver disease and a complete autoimmune and viral workup was unremarkable. Unfortunately, the patient developed widespread metastatic disease and passed away 5 months after his initial diagnosis. The mechanism of hepatocellular carcinoma in patients’ with Crohn’s disease is poorly understood and may include both autoimmunity and treatment-related complications. Previous case reports suggest the possibility of a concerning association between azathioprine therapy and the development of hepatocellular carcinoma in patients with Crohn’s disease. Clinicians may consider early imaging in patients with Crohn’s disease presenting with concerning symptomatology or abnormal liver enzymes, especially in those being treated with azathioprine alone or in combination with infliximab. Future research may help to uncover additional risk factors for this exceedingly rare diagnosis in this patient population. |
| format | Article |
| id | doaj-art-1f0051012875493dae86eef2dcd2af8e |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-1f0051012875493dae86eef2dcd2af8e2025-02-03T01:31:38ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362014-01-01201410.1155/2014/340836340836Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature ReviewKyle J. Fortinsky0Ali Alali1Khursheed Jeejeebhoy2Sandra Fischer3Morris Sherman4Scott Fung5Department of Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON, M5G 2C4, CanadaDepartment of Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON, M5G 2C4, CanadaDepartment of Medicine, Home Nutrition, St. Michael’s Hospital, Toronto, ON, M5B 1W8, CanadaDepartment of Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON, M5G 2C4, CanadaDepartment of Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON, M5G 2C4, CanadaDepartment of Medicine, Toronto General Hospital, 200 Elizabeth Street, Toronto, ON, M5G 2C4, CanadaHepatocellular carcinoma most commonly occurs in patients with underlying liver disease or cirrhosis. We describe a case of hepatocellular carcinoma in a 34-year-old man with Crohn’s disease treated with azathioprine and infliximab. The patient had no history of liver disease and a complete autoimmune and viral workup was unremarkable. Unfortunately, the patient developed widespread metastatic disease and passed away 5 months after his initial diagnosis. The mechanism of hepatocellular carcinoma in patients’ with Crohn’s disease is poorly understood and may include both autoimmunity and treatment-related complications. Previous case reports suggest the possibility of a concerning association between azathioprine therapy and the development of hepatocellular carcinoma in patients with Crohn’s disease. Clinicians may consider early imaging in patients with Crohn’s disease presenting with concerning symptomatology or abnormal liver enzymes, especially in those being treated with azathioprine alone or in combination with infliximab. Future research may help to uncover additional risk factors for this exceedingly rare diagnosis in this patient population.http://dx.doi.org/10.1155/2014/340836 |
| spellingShingle | Kyle J. Fortinsky Ali Alali Khursheed Jeejeebhoy Sandra Fischer Morris Sherman Scott Fung Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review Case Reports in Gastrointestinal Medicine |
| title | Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review |
| title_full | Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review |
| title_fullStr | Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review |
| title_full_unstemmed | Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review |
| title_short | Metastatic Hepatocellular Carcinoma in a Patient with Crohn’s Disease Treated with Azathioprine and Infliximab: A Case Report and Literature Review |
| title_sort | metastatic hepatocellular carcinoma in a patient with crohn s disease treated with azathioprine and infliximab a case report and literature review |
| url | http://dx.doi.org/10.1155/2014/340836 |
| work_keys_str_mv | AT kylejfortinsky metastatichepatocellularcarcinomainapatientwithcrohnsdiseasetreatedwithazathioprineandinfliximabacasereportandliteraturereview AT alialali metastatichepatocellularcarcinomainapatientwithcrohnsdiseasetreatedwithazathioprineandinfliximabacasereportandliteraturereview AT khursheedjeejeebhoy metastatichepatocellularcarcinomainapatientwithcrohnsdiseasetreatedwithazathioprineandinfliximabacasereportandliteraturereview AT sandrafischer metastatichepatocellularcarcinomainapatientwithcrohnsdiseasetreatedwithazathioprineandinfliximabacasereportandliteraturereview AT morrissherman metastatichepatocellularcarcinomainapatientwithcrohnsdiseasetreatedwithazathioprineandinfliximabacasereportandliteraturereview AT scottfung metastatichepatocellularcarcinomainapatientwithcrohnsdiseasetreatedwithazathioprineandinfliximabacasereportandliteraturereview |