Masuda Takuya, Yoshida Atsushi, Ueno Fumiaki, Hara Shintaro, Nabeta Haruaki, Umezawa Shotaro, Shirai Mayuki, Morikawa Yoshihide, Morizane Toshio, Endo Yutaka, Hibi Toshifumi
Center for Gastroenterology and Inflammatory Bowel Disease, Ofuna Chuo Hospital, Kamakura, Japan.
Center for Advanced IBD Research and Treatment, Kitasato Institute Hospital, Tokyo, Japan.
Inflamm Intest Dis. 2019 May;4(1):35-40. doi: 10.1159/000497778. Epub 2019 Mar 25.
A 40-year-old man with refractory ulcerative colitis (UC) was treated with tumor necrosis factor α inhibitor (anti-TNFα), infliximab. One month later, the chest computed tomography and laboratory test showed noninfectious interstitial lung disease (ILD) and elevation of serum Krebs von den Lungen-6 (KL-6). Fortunately, ILD disappeared after the discontinuation with anti-TNFα. Two and a half years after his first UC treatment, he was treated again with another anti-TNFα, adalimumab, for relapse and he had a second ILD. This course suggested anti-TNFα induced ILD. The characteristics of anti-TNFα-induced ILD in inflammatory bowel disease (IBD) are not well understood. We summarized and investigated the characteristics of such patients based on a literature review including 15 cases. It suggested that anti-TNFα-induced ILD in IBD might be rare and tends to have a better outcome compared with ILD in rheumatoid arthritis.
一名患有难治性溃疡性结肠炎（UC）的40岁男性接受了肿瘤坏死因子α抑制剂（抗TNFα）英夫利昔单抗治疗。1个月后，胸部计算机断层扫描和实验室检查显示为非感染性间质性肺疾病（ILD），血清克雷伯斯-冯-登-卢根-6（KL-6）升高。幸运的是，停用抗TNFα后ILD消失。在他首次接受UC治疗两年半后，因病情复发再次接受另一种抗TNFα药物阿达木单抗治疗，随后出现了第二次ILD。这个病程提示抗TNFα可诱发ILD。炎症性肠病（IBD）中抗TNFα诱发ILD的特征尚未完全明确。我们基于一项纳入15例病例的文献综述，总结并研究了此类患者的特征。结果表明，IBD中抗TNFα诱发的ILD可能较为罕见，与类风湿关节炎中的ILD相比，其预后往往更好。
