Song Yang, Shi Yan-Hong, He Chong, Liu Chang-Qin, Wang Jun-Shan, Zhao Yu-Jie, Guo Yan-Min, Wu Rui-Jin, Feng Xiao-Yue, Liu Zhan-Ju
Yang Song, Yan-Hong Shi, Chong He, Chang-Qin Liu, Jun-Shan Wang, Yu-Jie Zhao, Yan-Min Guo, Rui-Jin Wu, Xiao-Yue Feng, Zhan-Ju Liu, Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China.
World J Gastroenterol. 2015 May 21;21(19):6082-7. doi: 10.3748/wjg.v21.i19.6082.
Infliximab (IFX) is an anti-tumor necrosis factor chimeric antibody that is effective for treatment of autoimmune disorders such as Crohn's disease and ulcerative colitis (UC). IFX is well tolerated with a low incidence of adverse effects such as infections, skin reactions, autoimmunity, and malignancy. Dermatological manifestations can appear as infusion reaction, vasculitis, cutaneous infections, psoriasis, eczema, and skin cancer. Here, we present an unusual case of extensive and sporadic subcutaneous ecchymosis in a 69-year-old woman with severe UC, partial colectomy and cecostomy, following her initial dose of IFX. The reaction occurred during infliximab infusion, and withdrawal of IFX led to gradual alleviation of her symptoms. We concluded that Henoch-Schönlein purpura, a kind of leukocytoclastic vasculitis, might have contributed to the development of the bruising. Although the precise mechanisms of the vasculitis are still controversial, such a case highlights the importance of subcutaneous adverse effects in the management of UC with IFX.
英夫利昔单抗（IFX）是一种抗肿瘤坏死因子嵌合抗体，对治疗自身免疫性疾病如克罗恩病和溃疡性结肠炎（UC）有效。IFX耐受性良好，不良反应发生率低，如感染、皮肤反应、自身免疫和恶性肿瘤。皮肤表现可表现为输液反应、血管炎、皮肤感染、银屑病、湿疹和皮肤癌。在此，我们报告一例69岁患有严重UC、接受部分结肠切除术和盲肠造口术的女性，在首次注射IFX后出现广泛散在性皮下瘀斑的罕见病例。该反应发生在英夫利昔单抗输注期间，停用IFX后症状逐渐缓解。我们得出结论，过敏性紫癜，一种白细胞破碎性血管炎，可能导致了瘀斑的形成。尽管血管炎的确切机制仍存在争议，但这样一个病例凸显了皮下不良反应在IFX治疗UC中的重要性。
