Severe adalimumab-induced thrombocytopenia in a patient with Crohn's disease

Casanova, M J; Chaparro, María; S, Martínez; Vicuña, Isabel; Gisbert, Javier P.

doi:10.1016/j.crohns.2012.04.001

Cited by 28 publications

(34 citation statements)

References 14 publications

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“…Isolated thrombocytopenia following the use of anti‐TNF drugs has been reported. There are multiple hypotheses as to the possible aetiology, including autoimmune platelet destruction secondary to antiplatelet antibodies, immune complexes triggering the complement cascade, another unknown autoimmune mechanism, or idiosyncratic reaction …”

Section: Aims and Methodsmentioning

confidence: 99%

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Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Shivaji

Sharratt

Thomas

et al. 2019

Aliment Pharmacol Ther

128

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Background: Biological therapy is currently widely used to treat IBD. Infliximab, adalimumab and golimumab are currently licensed anti-TNF therapies. Biosimilar anti-TNF monoclonal antibodies are increasingly used. Anti-TNF therapies are widely used and their adverse effects are well characterised, and may cause significant morbidity and mortality in a small proportion of exposed patients. Gastroenterologists need to understand the mechanisms for these effects, recognise these swiftly and manage such events appropriately. Aim:To cover the range of potential adverse reactions as a result of biologic therapy and specifically management of these events. Methods: A Medline and Pubmed search was undertaken. Search terms includedwere "anti-TNF," "infliximab" or "adalimumab" or "golimumab" combined with the keywords "ulcerative colitis" or "Crohn's disease" or "inflammatory bowel disease" and then narrowed to articles containing the keywords "complications," "side effects" or "adverse events" or "safety profile." International guidelines were also reviewed where relevant.Results: Adverse events discussed in this review include infusion reactions, blood disorders and infections (including bacterial, viral, fungal and opportunistic infections) as well as autoimmune, dermatological disorders, cardiac and neurological conditions. Malignancies including solid organ, haematological and those linked to viral disease are discussed. Conclusions:Anti-TNF therapy has wide-ranging effects on the immune system resulting in a spectrum of potential adverse events in a small proportion of patients.Research advances are improving the understanding, recognition and management of these adverse events.

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Section: Aims and Methodsmentioning

confidence: 99%

“…Thrombocytopenia has been reported to be prolonged after cessation of therapy. In severe cases this could persist for up to 6 months and also preclude exposure to any further anti‐TNF agents . This is likely to be a class effect and rechallenge with same class could be risky and therefore discouraged .…”

Section: Aims and Methodsmentioning

confidence: 99%

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Shivaji

Sharratt

Thomas

et al. 2019

Aliment Pharmacol Ther

128

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“…The first hypothesis is that anti-TNFα drugs can stimulate the production of antibodies, targeting hematologic cells by inducing the apoptosis of Th1 lymphocytes. Immune-mediated thrombocytopenia and neutropenia during treatment with anti-TNFα drugs, including adalimumab, have been reported (3,4). Although the mechanisms associated with anti-TNFα-induced thrombocytopenia and neutropenia are unclear, a hypothesis suggested that anti-TNFα drugs induce the apoptosis of Th1 lymphocytes and consequently leave a relative excess of Th2 lymphocytes.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Hemolytic Anemia during Adalimumab Treatment for Plaque Psoriasis

et al. 2015

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Adalimumab is commonly used to treat autoimmune diseases with few reported hematological adverse reactions. We herein describe the case of an 85-year-old Japanese man with plaque psoriasis who developed autoimmune hemolytic anemia (AIHA) after 3 years of adalimumab treatment. The patient suddenly developed hematuria and dyspnea on exertion while receiving adalimumab treatment. Laboratory data showed low hemoglobin levels and slightly increased reticulocyte counts, while direct and indirect antiglobulin tests were positive. The patient was diagnosed with AIHA which resolved after replacing the adalimumab treatment with prednisolone therapy. The findings from this case indicate that AIHA may be caused by long-term adalimumab treatment.

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“…Our previous experience does not indicate thrombocytopenia on the paleolithic ketogenic diet. However, low thrombocyte number is a well-known side effect of the use of adalimumab in Crohn's disease [14,15]. It is also noteworthy that a return to the strictest form of the paleolithic ketogenic diet resulted in an increase in thrombocyte number.…”

Section: Tóth Et Al 575mentioning

confidence: 99%

Crohn's disease successfully treated with the paleolithic ketogenic diet

Tóth¹,

Dabóczi²,

Howard³

et al. 2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review

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Severe adalimumab-induced thrombocytopenia in a patient with Crohn's disease

Cited by 28 publications

References 14 publications

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Review article: managing the adverse events caused by anti‐TNF therapy in inflammatory bowel disease

Autoimmune Hemolytic Anemia during Adalimumab Treatment for Plaque Psoriasis

Crohn's disease successfully treated with the paleolithic ketogenic diet

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