Maruyama Yuriko, Hisamatsu Tadakazu, Matsuoka Katsuyoshi, Naganuma Makoto, Inoue Nagamu, Ogata Haruhiko, Iwao Yasushi, Kanai Takanori, Hibi Toshifumi
Department of Internal Medicine, School of Medicine, Keio University, Japan.
Intern Med. 2012;51(16):2125-9. doi: 10.2169/internalmedicine.51.8005. Epub 2012 Aug 15.
Behçet's disease is a chronic relapsing disease with multiple organ system involvement, including the gastrointestinal tract, which is known as intestinal Behçet's disease. Intestinal Behçet's disease is often resistant to empirical treatments such as 5-aminosalicylic acid, immunomodulators and steroids and often causes a perforation, requiring surgical resection. Therefore, intestinal lesions are considered to be a poor prognostic factor in Behçet's disease. Recently, several reports have demonstrated the efficacy of anti-TNFα monoclonal antibodies, such as infliximab, against intestinal Behçet's disease, however, it remains unknown whether anti-TNFα therapy can improve the prognosis of patients with intestinal Behçet's disease. We herein report the case of an adult female patient with intestinal Behçet's disease who responded well to the induction therapy with infliximab, and has been maintained in remission by scheduled administration of infliximab. Her C-reactive protein level has been sustained at a negative level, and endoscopic findings revealed complete mucosal healing. Therefore, infliximab may have the potential to induce "sustained deep remission" in patients with intestinal Behçet's disease.
白塞病是一种累及多个器官系统的慢性复发性疾病，包括胃肠道，称为肠道白塞病。肠道白塞病通常对经验性治疗如5-氨基水杨酸、免疫调节剂和类固醇耐药，且常导致穿孔，需要手术切除。因此，肠道病变被认为是白塞病预后不良的因素。最近，一些报告显示抗TNFα单克隆抗体如英夫利昔单抗对肠道白塞病有效，然而，抗TNFα治疗是否能改善肠道白塞病患者的预后仍不清楚。我们在此报告一例成年女性肠道白塞病患者，她对英夫利昔单抗诱导治疗反应良好，并通过定期使用英夫利昔单抗维持缓解。她的C反应蛋白水平一直维持在阴性，内镜检查结果显示黏膜完全愈合。因此，英夫利昔单抗可能有潜力诱导肠道白塞病患者实现“持续深度缓解”。
