Fujikawa Keita, Endo Yushiro, Mizokami Akinari, Takahashi Kosuke, Tabuchi Maiko, Ohba Kazuo, Nakamura Hideki, Kawakami Atsushi
Department of Rheumatology, Japan Community Healthcare Organization (JCHO), Isahaya General Hospital, Japan.
Intern Med. 2016;55(10):1375-8. doi: 10.2169/internalmedicine.55.6590. Epub 2016 May 15.
A 36-year-old Japanese woman with intestinal Behcet's disease was admitted to our hospital due to a recurrent ileocecal ulcer. Because infliximab (IFX) showed secondary failure, IFX was switched to adalimumab (ADA). After the third injection of ADA, she was unexpectedly 4-weeks pregnant. ADA was continued until 20 gestational weeks. Remission of the disease activity was maintained during pregnancy, and the birth was uneventful. The ileocecal ulcer disappeared after her delivery. ADA was detected in the umbilical blood after 119 days from the last infusion. The placental transition and timing of neonatal vaccination should be considered in cases of pregnancy with TNF antibody therapy.
一名36岁的日本女性肠道白塞病患者因回盲部溃疡复发入院。由于英夫利昔单抗（IFX）出现继发性失效，遂将IFX换为阿达木单抗（ADA）。在第三次注射ADA后，她意外怀孕4周。ADA持续使用至孕20周。孕期疾病活动度维持缓解，分娩过程顺利。产后回盲部溃疡消失。末次输注后119天，脐血中检测到ADA。对于接受肿瘤坏死因子抗体治疗的孕妇，应考虑胎盘转运及新生儿疫苗接种时机。
