Cortical Vein Thrombosis after Infliximab Treatment for Crohn's Disease

Area of Science:

• Gastroenterology and Hematology
• Vascular Medicine
• Pharmacology

Background:

• Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn's disease, is associated with a heightened risk of thromboembolic events.
• Patients with IBD, particularly Crohn's disease, may receive infliximab, a biologic agent that can further elevate the risk of thrombosis.
• While deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are recognized complications, other venous systems like cerebral, mesenteric, and portal veins can also be affected.

Observation:

• This report details a patient with Crohn's disease who developed an unusual thrombotic event.
• The patient experienced isolated thrombosis of the right Labbe vein.
• This occurred subsequent to receiving infliximab therapy for active and fistulating Crohn's disease.

Findings:

• The case presents as the first reported instance of isolated cortical vein thrombosis in a patient treated with infliximab for Crohn's disease.
• The thrombosis specifically affected the cortical veins, a less commonly reported site in this context.
• The temporal association suggests a potential link between infliximab therapy and this specific thrombotic event.

Implications:

• This case underscores the importance of vigilance for thromboembolic complications in IBD patients, even those treated with biologics like infliximab.
• It expands the spectrum of potential venous thrombotic events associated with infliximab therapy.
• Further research may be warranted to elucidate the precise mechanisms linking infliximab to cortical vein thrombosis and to refine risk stratification and management strategies in IBD patients.