Internal and Emergency Medicine Department, Hospital Careggi, Florence, Italy.
J Gastrointestin Liver Dis. 2011 Jun;20(2):201-3.
The anti-tumor necrosis factor (TNF) agents are drugs that in recent years turned out to be a mainstay of therapy for the treatment of inflammatory bowel disease. Nevertheless, they have several adverse effects such as infectious complications and immunogenicity. One of the most common immunogenic effects is the development of autoantibodies, mainly anti-nuclear antibodies and anti-double-stranded DNA antibodies, only rarely associated with overt clinical manifestations of systemic lupus erythematosus. Adalimumab is a fully humanized monoclonal antibody widely used for the treatment of Crohn's disease and supposed to have less immunogenic activity and a safer profile than other anti-TNF agents. The occurrence of systemic lupus erythematosus with involvement of the central nervous system appears to be a very rare complication of such drugs, and no cases have been reported in the medical literature in patients treated with adalimumab. We report a case of a 53 years-old woman with ileo-colic Crohn's disease where the treatment with adalimumab was complicated by systemic lupus erythematosus with central nervous system vasculitis.
抗肿瘤坏死因子（TNF）药物是近年来治疗炎症性肠病的主要药物。然而，它们有几个不良反应，如感染并发症和免疫原性。最常见的免疫原性作用之一是产生自身抗体，主要是抗核抗体和抗双链 DNA 抗体，但很少与系统性红斑狼疮的明显临床表现相关。阿达木单抗是一种广泛用于治疗克罗恩病的全人源化单克隆抗体，据报道其免疫原性活性较低，安全性优于其他抗 TNF 药物。累及中枢神经系统的系统性红斑狼疮的发生似乎是此类药物的一种非常罕见的并发症，在使用阿达木单抗治疗的患者的医学文献中尚未报告过此类病例。我们报告了一例 53 岁女性患有回肠结肠克罗恩病，使用阿达木单抗治疗后并发中枢神经系统血管炎的系统性红斑狼疮。
