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

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

Ülseratif Koliti Komplike Eden Romatoid Paternli Poliartropatide Kısa Dönem Infliximab Yanıtı

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

___

  • Andrisani G, Guidi L, Papa A, Armuzzi A. Anti-TNF alpha therapy in the management of extraintestinal manifestation of inflammatory bowel disease. Eur Rev Med Pharmacol Sci. 2012;16:890-901.
  • D'Incà R, Podswiadek M, Ferronato A, Punzi L, Salvagnini M, Sturniolo GC. Articular manifestations in inflammatory bowel disease patients: a prospective study. Dig Liver Dis 2009;41:11565-9.
  • Orchard TR, Orchard TR, Wordsworth BP, Jewell DP. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 1998;42:387-91.
  • Dorofeyev AE, Vasilenko IV, Rassokhina OA. Joint extraintestinal manifestations in ulcerative colitis. Dig Dis 2009;27: 502-10.
  • Boyer F, Fontanges E, Miossec P. Rheumatoid arthritis associated with ulcerative colitis: a case with severe flare of both diseases after delivery. Ann Rheum Dis. 2001;60:901. Ulker A, et al. Peripheral arthritis in the course of inflammatory bowel diseases. Dig Dis Sci. 2011;56:183-7.
  • Orchard TR, Thiyagaraja S, Welsh KI, Wordsworth BP, Hill Gaston JS, Jewell DP. Clinical phenotype is related to HLA genotype in the peripheral arthropathies of inflammatory bowel disease. Gastroenterology. 2000;118:274-8.
  • Cruz VA, Yamaguchi L, Ribeiro CN, Magalhães Vde O, Rego J, Silva NA. Ulcerative colitis and rheumatoid arthritis: a rare association--case report. Rev Bras Reumatol. 2012;52:648-50.
  • Lesuis N, Befrits R, Nyberg F, van Vollenhoven RF. Gender and the treatment of immune-mediated chronic inflammatory diseases: rheumatoid arthritis, inflammatory bowel disease and psoriasis: an observational study. BMC Med. 2012;10:82.
  • Kollias G, Douni E, Kassiotis G, Kontoyiannis D. On the role of tumor necrosis factor and receptors in models of multiorgan failure, rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. Immunol Rev. 1999;169:175-94.
Çukurova Üniversitesi Tıp Fakültesi Dergisi-Cover
  • ISSN: 0250-5150
  • Yayın Aralığı: 4
  • Yayıncı: Tülay Candan
Sayıdaki Diğer Makaleler

Adiponectin and Leptin Synovial Fluid Concentration as a Marker for the Severity of Knee Osteoarthritis in Obese Patients

Eddy Mart SALİM, Radiyati Umi PARTAN, Muhammad MUKTİ, Syarifuddin MUHAMMAD

Use of Intraperitoneal and Port Site Infiltration of Bupivacaine for Controlling Pain after Laparoscopic Cholecystectomy: A Prospective Study

Ubaid ALİ, Hanief Mohammed DAR, Mir Mujtaba AHMED, Nazir Ahmed SALROO, Shah Touseef ARJMAND, Sheikh İMRAN

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

Erkan KOZANOĞLU, İlke COŞKUN BENLİDAYI, Emine Aygül ORTAÇ

Pregnancy with Bilateral Dermoid Cyst and Unilateral Ovarian Torsion: a Case Report

Efser ÖZTAŞ, Sibel ÖZLER, Nuri DANIŞMAN, Dilek Uygur ŞAHİN, Ayşe KIRBAŞ, Ali Özgür ERSOY

Congenital Bronchial Artery - Pulmonary Artery Fistula in a

Sibel KARA, Uğur ÖZKAN, Nazan ŞEN, M Şule AKÇAY

Role of the Hereditary Thrombophilic Abnormalities in

Handan CANAN, A Nihal DEMİRCAN

Eskişehir'de Eczane Teknisyenleri üzerine Bir Araştırma

Mehlika Dilek ALTINTOP, Ahmet ÖZDEMİR, Belgin SEVER

Prescription Pattern and Potential Drug-Drug Interactions of Antihypertensive Drugs in a General Hospital, South Ethiopia

Fanta Gashe FUFA, Dereje MİRKANO, Ramenjiredi TİPATHİ

Çocukluk Çağı Akut Lösemilerinde Serum Tümör Nekroze Edici Faktör (TNF) (TRAIL) Prognostik Önemi

Barbaros Şahin KARAGÜN, Zeliha HAYTOGLU, Yurdanur KILINÇ, Bülent ANTMEN

Can Intra Oral Periapical Radiographs be Used as an Adjunct Diagnostic Marker in Detecting Underlying Systemic Diseases? A Randomised Case Control Study'

Preethi BALAN, Fazıl KA, Subhas BABU, Shishir Ram SHETTY, Renita Lorina CASTELİNO, Anusha Rangare LAXMANA