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Infliximab-induced lupus in Crohn's disease: a case report
P Sarzi-Puttini1, S Ardizzone, G Manzionna
1Rheumatology Unit, L Sacco University Hospital, Milan, Italy. sarzi@tiscali.it
Summary
This case study reports the first instance of prolonged drug-induced lupus in a patient treated with infliximab for Crohn's disease. Symptoms persisted for months after infliximab withdrawal, highlighting a significant clinical observation.
Area of Science:
- Rheumatology
- Immunology
- Gastroenterology
Background:
- Infliximab is a biologic therapy used for inflammatory conditions like Crohn's disease.
- Drug-induced lupus erythematosus (DILE) is a known, albeit rare, side effect of certain medications.
- The development of DILE necessitates careful patient monitoring during biologic therapy.
Observation:
- An 18-year-old male on infliximab for refractory Crohn's disease developed symptoms of systemic lupus erythematosus (SLE), including arthralgia, skin lesions, and malar rash.
- Laboratory tests revealed positive antinuclear antibodies and anti-double-stranded DNA antibodies.
- A diagnosis of infliximab-induced lupus was made, and the medication was discontinued.
Findings:
- Despite infliximab withdrawal, the patient exhibited persistent SLE symptoms for three months.
- Anti-double-stranded DNA antibodies normalized, and SLE symptoms resolved after six months.
- This represents the first reported case of prolonged DILE associated with infliximab therapy.
Implications:
- Physicians should be vigilant for prolonged lupus-like symptoms in patients treated with infliximab.
- The findings suggest a potential for sustained autoimmune responses even after drug cessation.
- Further research is warranted to understand the mechanisms and long-term implications of infliximab-induced lupus.