Background: Ustekinumab is a fully human monoclonal antibody which binds Interleukin
(IL)-12/23. It is indicated for the treatment of moderate-severe psoriasis and active psoriatic arthritis.
Few data are available about the possibility of an interaction between ustekinumab and the liver.
Case Description: We reported a case of a 61-year old woman admitted to our Unit for severe
transaminase elevation (aspartate transaminase 756 IU/l, alanine transaminase 1212 IU/l) occurred after
a single Ustekinumab infusion for psoriasis. All other possible causes of liver damage, including drugs,
hepatitis viruses, auto-antibodies and metabolic disorders were excluded. Liver biopsy showed
lymphocytic infiltration, biliary duct damage and piecemeal necrosis. On the bases of the nonspecific
histological picture and Rucam score, we accomplished the diagnosis of “liver injury of iatrogenic
origin”. After drug withdrawal, a spontaneous normalization of liver enzymes occurred within six
Keywords: Ustekinumab, drug-induced liver injury, transaminase elevation, liver, adverse events, HBV, HCV.
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