Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
MedStar Georgetown University Hospital, Washington, District of Columbia, USA.
BMJ Case Rep. 2021 Jun 28;14(6):e243337. doi: 10.1136/bcr-2021-243337.
Infliximab, an antitumour necrosis factor alpha (TNF-alpha)agent, is a cornerstone of treatment of inflammatory bowel disease with a favourable and well-tolerated side effect profile. While the majority of side effects associated with infliximab have been well established, the pathophysiology of infliximab-associated thrombosis remains controversial and poorly defined. We present a case of a young woman with ulcerative colitis who presented with a right ventricular thrombus and bilateral pulmonary emboli after initiation of infliximab and was subsequently found to have underlying factor V Leiden and prothrombin gene mutation. Clinicians should be aware of this potential adverse event associated with anti-TNF agents, especially in individuals with predisposing prothrombotic mutations such as factor V Leiden or prothrombin gene mutation.
英夫利昔单抗是一种抗肿瘤坏死因子-α（TNF-α）的药物，是治疗炎症性肠病的基石，具有良好的耐受性和可接受的副作用。虽然与英夫利昔单抗相关的大多数副作用已得到充分证实，但英夫利昔单抗相关血栓形成的病理生理学仍存在争议且定义不明确。我们报告了一例溃疡性结肠炎年轻女性的病例，在开始使用英夫利昔单抗后出现右心室血栓和双侧肺栓塞，随后发现存在潜在的因子 V Leiden 和凝血酶原基因突变。临床医生应意识到与抗 TNF 药物相关的这种潜在不良事件，特别是在存在易栓形成突变（如因子 V Leiden 或凝血酶原基因突变）的个体中。
