Nishikawa Jun, Hosokawa Ayumu, Akashi Momoko, Mihara Hiroshi, Nanjo Sohachi, Yoshita Hiroki, Ando Takayuki, Kajiura Shinya, Fujinami Haruka, Sugiyama Toshiro
Department of Internal Medicine, Saiseikai Toyama Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2015 Oct;112(10):1852-7. doi: 10.11405/nisshoshi.112.1852.
Anti-TNF-α inhibitors have been widely used in the treatment of inflammatory bowel disease. Although they have good clinical efficacy and tolerance, they remain a matter of concern because they cause drug-induced autoimmune disorders as side effects. Here, we report a case of a patient with Crohn's disease who developed IgA vasculitis after infliximab and adalimumab treatment. A 17-year-old male with Crohn's disease who had received scheduled infliximab treatment for the preceding 19 months complained of purpura on his lower limbs. He was diagnosed with infliximab-induced IgA vasculitis. Switching infliximab to adalimumab resulted in rapid improvement of the condition. However, 21 months after switching to adalimumab, his purpura recurred. Drug-induced IgA vasculitis is a rare complication caused by infliximab and adalimumab; however, diagnosis in the early phase and appropriate management of patients receiving anti-TNF-α inhibitors is critical to a successful patient outcome.
抗TNF-α抑制剂已广泛应用于炎症性肠病的治疗。尽管它们具有良好的临床疗效和耐受性，但由于会引起药物性自身免疫性疾病作为副作用，仍然令人担忧。在此，我们报告一例克罗恩病患者在接受英夫利昔单抗和阿达木单抗治疗后发生IgA血管炎的病例。一名17岁患有克罗恩病的男性，在过去19个月中接受了定期英夫利昔单抗治疗，他抱怨下肢出现紫癜。他被诊断为英夫利昔单抗诱导的IgA血管炎。将英夫利昔单抗换为阿达木单抗后病情迅速改善。然而，在换用阿达木单抗21个月后，他的紫癜复发。药物性IgA血管炎是由英夫利昔单抗和阿达木单抗引起的罕见并发症；然而，对接受抗TNF-α抑制剂治疗的患者进行早期诊断和适当管理对于患者的成功治疗结果至关重要。
