Hoffmann Sebastian, Berneburg Mark, Schreml Stephan
Department of Dermatology, University Medical Center Regensburg, Regensburg, Germany.
Case Rep Dermatol. 2018 May 24;10(2):145-148. doi: 10.1159/000489163. eCollection 2018 May-Aug.
Bullous pemphigoid (BP) is a blistering autoimmune disease mainly observed in elderly patients. Several triggers are known for this autoimmune disease and some drugs are known to be a cause of BP. However, there are only few case reports on the induction of BP under adalimumab therapy. Other autoimmune diseases, such as lupus erythematosus, are also known to occur under TNF inhibition. Here, we report on an 81-year-old patient who received adalimumab for ulcerative colitis and subsequently developed BP. Other causes of BP (tumors, other drugs, viral or toxoplasma infections) were excluded. We initiated a topical and systemic therapy (prednisolone 1 mg/kg/day) and stopped the adalimumab injections. The patient's symptoms resolved quickly and we were able to taper corticosteroid therapy. This rare case highlights the importance to monitor for autoimmune events during TNF inhibition.
大疱性类天疱疮（BP）是一种主要见于老年患者的水疱性自身免疫性疾病。已知有多种诱因可引发这种自身免疫性疾病，并且已知某些药物可导致BP。然而，关于在阿达木单抗治疗下诱发BP的病例报告很少。其他自身免疫性疾病，如红斑狼疮，也已知在肿瘤坏死因子（TNF）抑制作用下发生。在此，我们报告一名81岁的患者，其因溃疡性结肠炎接受阿达木单抗治疗，随后发生了BP。排除了BP的其他病因（肿瘤、其他药物、病毒或弓形虫感染）。我们启动了局部和全身治疗（泼尼松龙1 mg/kg/天）并停止了阿达木单抗注射。患者的症状迅速缓解，我们得以逐渐减少皮质类固醇治疗。这个罕见病例凸显了在TNF抑制期间监测自身免疫事件的重要性。
