Altuwaijri Mansour A, Aljasser Maha J
Department of Medicine, College of Medicine, King Khaled University Hospital, Riyadh 12372, Saudi Arabia.
Department of Medicine, College of Medicine, King Khaled University Hospital, Riyadh 12372, Saudi Arabia.
Arab J Gastroenterol. 2022 Nov;23(4):288-289. doi: 10.1016/j.ajg.2022.06.008. Epub 2022 Oct 10.
Crohn's disease can be characterized as a chronic inflammatory state causing various clinical presentations and long-term risks that should be considered when determining the optimal therapeutic strategy. To date, while a few case reports have been available regarding ustekinumab-induced thrombocytopenia, none are available regarding hypersplenism. We describe a 33-year-old woman who developed only Ileocolonic Crohn's disease on ustekinumab due to failure of anti-TNF with septic shock and thrombocytopenia. Abdominal computed tomography revealed hepatosplenomegaly, parasacral collection, and fistulization. The patient was transferred to the intensive care unit and managed accordingly. Various treatment modalities were attempted, but none of them improved her platelet count. Our case report demonstrates that ustekinumab may induce hypersplenism and subsequently thrombocytopenia and should be considered a potential cause of low platelet count.
克罗恩病可表现为一种慢性炎症状态，会引发多种临床表现及长期风险，在确定最佳治疗策略时应予以考虑。迄今为止，虽然已有一些关于优特克单抗诱发血小板减少症的病例报告，但尚无关于脾功能亢进的报告。我们描述了一名33岁女性，她因抗TNF治疗失败并伴有感染性休克和血小板减少症，在使用优特克单抗后仅出现回结肠型克罗恩病。腹部计算机断层扫描显示肝脾肿大、骶旁积液和瘘管形成。该患者被转入重症监护病房并进行相应处理。尝试了各种治疗方法，但均未改善她的血小板计数。我们的病例报告表明，优特克单抗可能诱发脾功能亢进，继而导致血小板减少症，应被视为血小板计数降低的一个潜在原因。
