Infliximab Induced Cardiac Tamponade

Area of Science:

• Immunology
• Gastroenterology
• Cardiology

Background:

• Ulcerative Colitis (UC) is a chronic inflammatory bowel disease.
• Infliximab is a biologic therapy targeting tumor necrosis factor-alpha (TNFα) used for UC treatment.
• Adverse reactions to anti-TNFα therapy can occur, necessitating careful monitoring.

Observation:

• A patient with Ulcerative Colitis developed cardiac tamponade during Infliximab induction therapy.
• Initial presentation included tachycardia, hypotension, fever, and elevated inflammatory/infective markers, mimicking infection.
• Cardiac tamponade was identified as the cause of these symptoms.

Findings:

• The cardiac tamponade was attributed to a type 3 hypersensitivity immune-complex reaction.
• This reaction led to a reactive pericardial effusion.
• The findings highlight a rare but serious complication of Infliximab therapy.

Implications:

• Autoimmune reactions to anti-TNFα therapy can present atypically, mimicking infectious processes.
• Clinicians should consider drug-induced autoimmune reactions in patients on anti-TNFα therapy with unexplained symptoms.
• Early recognition and management are crucial for favorable outcomes in such cases.