Infliximab-induced lupus in Crohn's disease: A case report

P. Sarzi-Puttini, S. Ardizzone, G. Manzionna, F. Atzeni, E. Colombo, M. Antivalle, M. Carrabba, G. Bianchi-Porro

Research output: Contribution to journalArticle

Abstract

An 18-year-old male patient was under treatment with infliximab at a dose of 5 mg/kg at Weeks 0, 2 and 6 for refractory Crohn's disease. In June 2002, the patient was admitted to the Outpatient Clinic of the Rheumatology Unit for arthralgia affecting the small joints, non-pruritic crops of purple skin lesions and malar rash in the face. Serum antinuclear antibodies were positive (1:640 speckled pattern), and anti-double-stranded DNA was positive (1:80); moreover, positivity of anti-extractable nuclear antigen was observed. Antihistone antibodies, lupus anticoagulant and anticardiolipin antibodies were negative. A diagnosis of infliximab-induced lupus was made and the drug treatment was withdrawn. However, 3 months after withdrawal of treatment, the patient still showed clinical and laboratory symptoms of systemic lupus erythematosus. After 6 months of treatment, systemic lupus erythematosus-related symptoms disappeared and anti-double-stranded DNA returned to normal. The patient is currently under treatment with prednisone 20 mg/day for systemic lupus erythematosus and with oral mesalazine 2.4 mg/day for Crohn's disease. Treatment with infliximab is known to produce an increase of autoantibodies (antinuclear antibodies, anti-double-stranded DNA), but not clinical disease. This is the first case, to our knowledge, of onset of prolonged infliximab-induced lupus.

Original languageEnglish
Pages (from-to)814-817
Number of pages4
JournalDigestive and Liver Disease
Volume35
Issue number11
DOIs
Publication statusPublished - Nov 2003

Fingerprint

Crohn Disease
Systemic Lupus Erythematosus
Antinuclear Antibodies
DNA
Therapeutics
Mesalamine
Lupus Coagulation Inhibitor
Anticardiolipin Antibodies
Nuclear Antigens
Arthralgia
Rheumatology
Prednisone
Ambulatory Care Facilities
Exanthema
Autoantibodies
Infliximab
Joints
Skin
Antibodies
Serum

Keywords

  • Crohn's disease
  • Infliximab
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Sarzi-Puttini, P., Ardizzone, S., Manzionna, G., Atzeni, F., Colombo, E., Antivalle, M., ... Bianchi-Porro, G. (2003). Infliximab-induced lupus in Crohn's disease: A case report. Digestive and Liver Disease, 35(11), 814-817. https://doi.org/10.1016/S1590-8658(03)00448-1

Infliximab-induced lupus in Crohn's disease : A case report. / Sarzi-Puttini, P.; Ardizzone, S.; Manzionna, G.; Atzeni, F.; Colombo, E.; Antivalle, M.; Carrabba, M.; Bianchi-Porro, G.

In: Digestive and Liver Disease, Vol. 35, No. 11, 11.2003, p. 814-817.

Research output: Contribution to journalArticle

Sarzi-Puttini, P, Ardizzone, S, Manzionna, G, Atzeni, F, Colombo, E, Antivalle, M, Carrabba, M & Bianchi-Porro, G 2003, 'Infliximab-induced lupus in Crohn's disease: A case report', Digestive and Liver Disease, vol. 35, no. 11, pp. 814-817. https://doi.org/10.1016/S1590-8658(03)00448-1
Sarzi-Puttini P, Ardizzone S, Manzionna G, Atzeni F, Colombo E, Antivalle M et al. Infliximab-induced lupus in Crohn's disease: A case report. Digestive and Liver Disease. 2003 Nov;35(11):814-817. https://doi.org/10.1016/S1590-8658(03)00448-1
Sarzi-Puttini, P. ; Ardizzone, S. ; Manzionna, G. ; Atzeni, F. ; Colombo, E. ; Antivalle, M. ; Carrabba, M. ; Bianchi-Porro, G. / Infliximab-induced lupus in Crohn's disease : A case report. In: Digestive and Liver Disease. 2003 ; Vol. 35, No. 11. pp. 814-817.
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