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Sami Karoui, Norsaf Bibani, Imed Ben Gorbel, Meriem Serghini, Mouna Mlika, Amel Braham, Ines Chelly, Slim Haouet, Habib Houmène, Azza Filali, Leukocytoclastic vasculitis: A rare adverse effect secondary to infliximab, Inflammatory Bowel Diseases, Volume 17, Issue 2, 1 February 2011, Pages E4–E5, https://doi.org/10.1002/ibd.21309
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To the Editor:
Targeted inhibition of tumor necrosis factor-α is an effective therapy in Crohn's disease (CD) and rheumatoid arthritis. Infliximab, a monoclonal murine-human chimeric antibody to TNF-α, is generally well tolerated.1,2 Significant autoimmunity, including drug-induced vasculitis, has been rarely reported.1 We report a case of cutaneous vasculitis developed in 1 patient with Crohn's disease and treated by infliximab.
A 47-year-old man suffering from Crohn's disease involving the colon since 1995 was admitted to our unit in 2006 for complex anal fistula refractory to treatment with antibiotics. The patient was treated by infliximab (3 infusions in weeks 0, 2 and 6) at a dose of 5 mg/kg/day with rapid favorable outcome, followed by maintenance therapy (1 infusion every 8 weeks) in association with treatment by azathioprine at a dose of 2,5 mg/kg/day. Twenty days after the 11th infusion, the patient consulted for the occurrence of nonpruritic skin lesions on the 2 lower legs associated with fever and mild arthralgias with no abdominal pain or diarrhea. He had not recently started any other new medications.
