AI Article Synopsis
- Crohn's disease (CD) is a serious inflammatory condition of the digestive tract influenced by genetics, the immune system, and the environment; infliximab is a treatment option specifically for its fistulated form.
- A 63-year-old man diagnosed with CD developed a rare, non-immune drug-induced hemolysis after receiving infliximab, which was treated successfully with steroids and led to improvements in his hemoglobin levels.
- Interestingly, despite the potential for cross-reactions among biological treatments, switching the patient to adalimumab after the hemolysis did not result in any further complications or reactions.
Article Abstract
Introduction: Crohn's disease (CD) is an idiopathic inflammatory disorder of unknown etiology with genetic, immunologic, and environmental influences. Infliximab is a treatment modality for fistulated Crohn's disease. Infliximab induced hemolysis is rare and very few cases reported before in Ulcerative colitis (UC) but not in Crohn's disease
Case Presentation: We are reporting a 63 years old gentleman who was diagnosed as Crohn's disease and started on Tumor necrosis factor Inhibitor (TNF) -α i.e. (infliximab - Remsima) infusion. The course was complicated by Coomb's negative hemolytic anemia which is suggestive of non-immune drug induced hemolysis. Our patient was treated with steroid and conservative measures. Upon following up, his hemoglobin level as well as all hemolytic markers showed dramatic improvement. Adalimumab was used to treat this patient as an alternative choice without relapse of hemolysis.
Clinical Discussion: Drug induced Hemolysis is not a well-known complication post receiving Tumor necrosis factor Inhibitor (TNF) -α infusion in patients with Crohn's disease. Coombs negative hemolysis keeps in favor of non-immune drug induced rather than other differentials in our case scenario.
Conclusion: Although cross-reactivity is expected between one biological agent to another, in our case the use of Adalimumab as alternative choice post Tumor necrosis factor Inhibitor (TNF) -α (Remsima infliximab) induced hemolysis did not cause hemolysis or any type of reaction.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403549 | PMC |
| http://dx.doi.org/10.1016/j.amsu.2021.102768 | DOI Listing |
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