Bellucca Simone, Calvo Pier Luigi, Giugliano Laura, Opramolla Anna
From the Dipartimento di Scienze della Sanità Pubblica e Pediatriche, University of Turin, Italy.
Ospedale Infantile Regina Margherita, Città della salute e della scienza di Torino, Turin, Italy.
JPGN Rep. 2023 Apr 24;4(2):e308. doi: 10.1097/PG9.0000000000000308. eCollection 2023 May.
Anti-TNF antibodies have become a first-line therapy in moderate-to-severe inflammatory bowel diseases. However, there may be some rare paradoxical events and those affecting joints causing severe symptoms need a scrupulous differential diagnosis. When these events occur, it may be necessary to discontinue treatment and shift to another drug class. Herein, we report the case of a 15-year-old boy affected by Crohn's disease, who developed a paradoxical reaction after the second dose of infliximab. Clinical remission was achieved shifting to budesonide and azathioprine and continuing maintenance therapy with azathioprine alone. To date, no other paradoxical events have occurred.
抗TNF抗体已成为中重度炎症性肠病的一线治疗方法。然而，可能会出现一些罕见的矛盾事件，那些影响关节并导致严重症状的事件需要进行仔细的鉴别诊断。当这些事件发生时，可能有必要停药并改用另一类药物。在此，我们报告一例15岁克罗恩病男孩的病例，该男孩在第二次注射英夫利昔单抗后出现了矛盾反应。改用布地奈德和硫唑嘌呤并仅用硫唑嘌呤继续维持治疗后实现了临床缓解。迄今为止，未发生其他矛盾事件。
