Successful use of adalimumab for treating fistulizing Crohn's disease with pyoderma gangrenosum

• 作 者: Eva Zold Arpad Nagy Katalin Devenyi Margit Zeher Zsolt Barta
• 机 构: Division of Clinical Immunology,3rd Department of Medicine,Medical and Health Science Center,Univers
• 出 处: World Journal of Gastroenterology
• 发表日期: 2009年18期
• 关键词: maintenance challenging erythema parenteral diarrhea birds remission indicative

Crohn’s disease(CD) is a chronic relapsing and remitting autoinflammatory disorder of the gastrointestinal tract that has many intestinal and extraintestinal complications.The purpose of treatment is long-term remission,reduction of complications,and improvement of patients’ quality of life.In many cases,this can be quite challenging and it is necessary to have a well thought out management strategy.We present the case of a 38-year-old woman with fistulizing CD that manifested as diffuse abdominal pain and bloody diarrhea accompanied by arthralgia.In addition,there were ulcerative lesions surrounded by cutaneous inflammation and erythema on her extremities,indicative of pyoderma gangrenosum.The patient was treated with high doses of parenteral methylprednisolone without any improvement and was started on adalimumab.A positive response to adalimumab therapy was observed:after 2 mo of therapy,the ulcerative skin lesion healed completely and the enterogastric fistula was closed after 5 mo adalimumab treatment.Adalimumab might be a suitable initial as well as maintenance therapy in patients with complicated CD.

Crohn’s disease (CD) is a chronic relapsing and remitting autoinflammatory disorder of the gastrointestinal tract that has many intestinal and extraintestinal complications. The purpose of treatment is long-term remission, reduction of complications, and improvement of patients’ quality of life. Many cases, this can be quite challenging and it is necessary to have a well thought out management strategy. We present the case of a 38-year-old woman with fistulizing CD that manifested as diffuse abdominal pain and bloody diarrhea accompanied by arthralgia. , there were ulcerative lesions surrounded by cutaneous inflammation and erythema on her extremities, indicative of pyoderma gangrenosum. The patient was treated with high doses of parenteral methylprednisolone without any improvement and was started on adalimumab. A positive response to adalimumab therapy was observed: after 2 mo of therapy, the ulcerative skin lesion healed completely and the enterogastric fistula was closed after 5 mo adalimumab treatment. Adalimumab might be a suitable initial as well as maintenance therapy in patients with complicated CD.