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Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
[Inflammatory bowel disease and lymphoproliferative disorders]
1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. bdye@amc.seoul.kr
The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|November 2, 2011
Summary
Patients with inflammatory bowel disease (IBD) have a similar or slightly increased risk of lymphoproliferative disorders (LPDs) compared to the general population. Thiopurine therapy moderately increases LPD risk, while methotrexate appears low risk.
Area of Science:
- Immunology
- Gastroenterology
- Oncology
Context:
- Autoimmune and chronic inflammatory diseases are associated with an increased risk of lymphoproliferative disorders (LPDs).
- Inflammatory bowel disease (IBD) patients may have a similar or slightly elevated risk of LPDs compared to the general population.
- Evaluating the impact of specific therapies on LPD risk in IBD is complex due to confounding factors and polypharmacy.
Purpose:
- To review the current understanding of lymphoproliferative disorder (LPD) risks in patients with inflammatory bowel disease (IBD).
- To assess the association between common IBD therapeutic agents and the risk of LPDs.
- To highlight specific risks, such as hepatosplenic T-cell lymphoma, associated with combination therapies.
Summary:
- The overall risk of LPDs in IBD patients is comparable to the general population.
- Thiopurine treatment is linked to a moderate increase in LPD risk.
- Methotrexate shows a low LPD risk, while anti-TNF-alpha agents' role is unclear due to frequent co-treatment with thiopurines.
Impact:
- Emphasizes the need for individualized risk-benefit assessments of immunosuppressive therapies in IBD management.
- Highlights the potential for serious adverse events, like hepatosplenic T-cell lymphoma, in specific patient subgroups on combination therapy.
- Informs clinical decision-making regarding the selection and monitoring of therapies for IBD patients to mitigate LPD risks.
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