Severe drug-induced liver injury related to therapy with dimethyl fumarate

Dimethyl fumarate (DMF) has been used for the treatment of severe psoriasis for many years and only recently been licensed as first-line therapy for relapsing-remitting multiple sclerosis (MS). Safety assessments have shown only moderate elevations of liver enzymes during DMF treatment. Here we report the case of a 26-year-old female with MS presenting with initial elevation of aminotransferases two weeks after initiation of DMF (Tecfidera©) treatment and progress to severe liver failure with jaundice despite prompt cessation of DMF therapy with the first appearance of elevated liver enzymes. The patient was on…