Infliximab-Induced Lupus in Crohn's Disease
10.3904/kjm.2019.94.3.303
- Author:
Su Jin CHOI
1
;
Sohyun KIM
;
Hye Yeong KIM
;
Yongjune LEE
;
Dong Gon HYUN
;
Suk Kyun YANG
;
Yong Gil KIM
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. bestmd2000@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Infliximab;
Lupus erythematosus, Systemic;
Crohn disease
- MeSH:
Anemia, Hemolytic;
Arthralgia;
Arthritis, Rheumatoid;
Celecoxib;
Crohn Disease;
Female;
Humans;
Hydroxychloroquine;
Infliximab;
Lupus Erythematosus, Systemic;
Lymphocytes;
Middle Aged;
Necrosis;
Spondylitis, Ankylosing
- From:Korean Journal of Medicine
2019;94(3):303-307
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Infliximab (IFX) is an anti-tumor necrosis factor (TNF) monoclonal antibody used to treat rheumatoid arthritis, ankylosing spondylitis, and Crohn's disease. Rarely, anti-TNF-induced lupus (ATIL) may occur. ATIL differs from classical drug-induced lupus. We report a 49-year-old woman who developed polyarthralgia after 2 years of IFX treatment for Crohn's disease. Based on the autoantibody profiles, ATIL was diagnosed and low-dose glucocorticoid, hydroxychloroquine, and celecoxib were prescribed. However, arthralgia and hemolytic anemia developed. Because the anti-dsDNA titers waxed and waned, she was switched to vedolizumab, a monoclonal antibody to the human lymphocyte α4β7 integrin. Six months after switching treatment, the arthralgia had improved and the anti-dsDNA antibody normalized. Here, we report a case of ATIL that resolved after switching from infliximab to vedolizumab.
