Successful Anti-TNF-Alpha Therapy for Crohn’s Disease After Allogeneic Stem Cell Transplantation: A Case Report
| Autor: | Atsujiro Nishioka, Shinya Kimura, Haruna Sano, Yasushi Kubota, Kensuke Kojima, Mariko Yoshimura, Haruhiko Sano, Kazuharu Kamachi, Toshihiko Ando, Kyosuke Yamaguchi, Mariko Hashiguchi, Kana Kusaba, Nanae Tsuruoka, Masako Yokoo, Keisuke Kidoguchi |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Graft vs Host Disease Gastroenterology General Biochemistry Genetics and Molecular Biology Young Adult 03 medical and health sciences 0302 clinical medicine Crohn Disease immune system diseases Internal medicine medicine Adalimumab Humans Transplantation Homologous 030212 general & internal medicine Autoimmune disease Crohn's disease Tumor Necrosis Factor-alpha business.industry Umbilical Cord Blood Transplantation Remission Induction Antibodies Monoclonal General Medicine medicine.disease Combined Modality Therapy Hodgkin Disease Infliximab Transplantation Treatment Outcome surgical procedures operative Graft-versus-host disease 030220 oncology & carcinogenesis Female Cord Blood Stem Cell Transplantation Immunotherapy business Complication medicine.drug |
| Zdroj: | The Tohoku Journal of Experimental Medicine. 251:81-85 |
| ISSN: | 1349-3329 0040-8727 |
| DOI: | 10.1620/tjem.251.81 |
| Popis: | Graft-versus-host disease (GVHD) is a potentially life-threatening complication of allogeneic stem cell transplantation (Allo-SCT). Chronic GVHD, which typically presents more than 100 days after Allo-SCT, can resemble manifestations of autoimmune disease; however, there are only a few reports on the development of Crohn's disease (CD) after Allo-SCT. Here, we report a case of steroid-refractory CD after umbilical cord blood transplantation (CBT), which was dramatically improved with administration of anti-tumor necrosis factor-alpha (anti-TNF-alpha) antibodies. A 21-year-old woman with refractory Hodgkin lymphoma underwent CBT and achieved complete remission. About 1 year after CBT, she complained of intermittent abdominal pain and bloody diarrhea, and colonoscopy revealed multiple longitudinal colonic ulcers with a cobblestone appearance; thus, based on the colonoscopy findings, she was diagnosed with CD. We considered a CD-like manifestation of gastrointestinal GVHD and initially administered steroids, but the therapeutic effect was poor. Then, we administered anti-TNF-alpha antibodies, infliximab, and then adalimumab, which resulted in rapid improvement of abdominal symptoms, with no recurrence despite discontinuation of this therapy. Anti-TNF-alpha antibodies are effective for CD after Allo-SCT, which can be considered as a subsequent complication of GVHD. |
| Databáze: | OpenAIRE |
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