İlke BENLİDAYI, Erkan KOZANOĞLU, Emine ORTAÇ

Ülseratif Koliti Komplike Eden Romatoid Paternli Poliartropatide Kısa Dönem Infliximab Yanıtı

Ülseratif kolit, periferik ve aksiyel artropatiler gibi ekstraintestinal bulguların eşlik ettiği progresif bir inflamatuvar barsak hastalığıdır. Ülseratif kolitli hastalarda bazen romatoid artritten ayırt edilmesi zor olan romatoid paternli poliartropati görülebilmektedir. Bu yazıda, ülseratif koliti komplike eden romatoid paternli bir poliartropati vakası ve infliximab tedavisine verdiği olumlu yanıt sunulmaktadır. Ülseratif kolit tanısı almış 25 yaşında bir kadın hasta çeşitli eklemlerinde şişlik ve ağrı yakınmasıyla başvurdu. Laboratuar testlerinde akut faz reaktanları yüksekti. Metotreksat, sulfasalazin ve steroid kombinasyonuna yanıtsız olması nedeniyle hastaya infliximab tedavisi başlandı. Ağrı skorları ve biyokimyasal belirteçlerde düzelme gözlendi. Altı aylık anti-tümör nekrozis faktör (anti-TNF) tedavisi sonunda akut faz reaktanları düştü ve hasta asemptomatikti. Infliximab, ülseratif kolitle ilişkili romatoid paternli periferik poliartritte kullanılabilecek etkin bir tedavi seçeneğidir.

Short-Term Response to Infliximab in Rheumatoid Pattern Polyarthropathy Complicating Ulcerative Colitis

Ulcerative colitis (UC) is a progressive inflammatory disease (IBD) of the bowel which can be accompanied by extraintestinal findings such as peripheral and axial arthropathies. Patients with UC sometimes display rheumatoid pattern polyarthropathy which is challenging to differ from rheumatoid arthritis. We describe a case with rheumatoid pattern polyarthropathy complicating UC and her favourable response to infliximab therapy. A 25-year-old female with a diagnosis of UC was admitted due to swelling and pain in multiple joints. Laboratory tests revealed elevated acute phase reactants. Since the patient was refractory to the combination therapy comprising methotrexate, sulphasalazine and steroid, she was started on an infliximab regimen. She experienced an improvement both in terms of pain scores and biochemical findings. The patient was asymptomatic with reduced acute phase reactants following a 6-monthcourse of anti-tumor necrosis factor (anti-TNF) therapy. Infliximab serves as an effective treatment option for the management of rheumatoid pattern peripheral polyarthritis associated with UC.

Keywords:

anti-TNF, arthritis infliximab, polyarthropathy, ulcerative colitis,

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