Takayasu's Arteritis in a Patient with Crohn's Disease: An Unexpected Association during Infliximab Therapy

Katoh, Nagaaki; Kubota, Mayu; Shimojima, Yasuhiro; Ishii, Wataru; Matsuda, Masayuki; Akamatsu, Taiji; Ikeda, Shu‐ichi

doi:10.2169/internalmedicine.49.2491

Cited by 21 publications

(9 citation statements)

References 26 publications

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“…Similar cases of TA induced by TNF blockers have been reported in the literature. This situation was first described during Crohn's disease 9 10. To the best of our knowledge, only two cases of TA induced by TNF-α inhibitors in patients with rheumatic disease have been described: one of seropositive rheumatoid arthritis (RA) and the other of spondyloarthritis 11.…”

Section: Discussionmentioning

confidence: 99%

Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?

et al. 2014

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Takayasu’s arteritis (TA) is a rare granulomatous vasculitic disease. Recently, experimental studies and several case reports have supported the use of anti-tumour necrosis factor (TNF) therapy for severe forms of TA. We report a case of a 58-year-old woman who was followed for spondyloarthritis. Her disease was resistant to non-steroidal anti-inflammatory drugs, and TNF-α blockers were initiated. The patient developed asthaenia and severe back pain. The erythrocyte sedimentation rate was 82 mm and C reactive protein was 192 mg/L. Based on thickened walls of large vessel on MRI, a diagnosis of TA was established. Under corticosteroids and after discontinuation of TNF-α blockers, the patient remained free of symptoms at 8-month follow-up.

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Section: Discussionmentioning

confidence: 99%

Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?

et al. 2014

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“…The simultaneous occurrence of IBD and TA is considered rare [3,8]. Reports on IBD concomitant with TA have increased recently, however, although the reason for this is unclear [3,[7][8][9][10][11][12][13]. Until now, there have been 56 IBD cases concomitant with TA including our two cases, and the majority of cases were treated with corticosteroid therapy [3,[6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Effect of infliximab on inflammatory bowel disease with Takayasu arteritis: case series and review of the literature

Minami

Nakase

Yoshino

et al. 2013

Clin J Gastroenterol

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Takayasu arteritis (TA) and inflammatory bowel disease (IBD) are chronic inflammatory disorders. The mechanisms underlying these diseases are not precisely known, but tumor necrosis factor alpha (TNF-α) is considered to have an important role in the pathophysiology of both TA and IBD. Simultaneous occurrence of both TA and IBD is rare. Our first case was a 42-year-old woman with TA and inflammatory bowel disease unclassified. The patient was refractory to treatment with an immunomodulator, and infliximab (IFX) was started. After starting IFX, clinical remission was achieved and maintained for 2 years. The second case was a 34-year-old woman with TA accompanied by Crohn's disease. Because her abdominal symptoms relapsed despite treatment with an immunomodulator, IFX was started. Both diseases were well controlled for 2 years by scheduled maintenance therapy with IFX. Relapse of the TA required increased doses of IFX at shorter intervals, which relieved her symptoms. Overall, we identified nine cases for which IFX was effective, including our 2 cases. They may demonstrate the efficacy of IFX for IBD with TA and emphasize the role of TNF-α in the pathophysiology.

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“…CD preceded TD in about 50% of cases (57) and TD developed, while patients treated with corticosteroids, azathioprine and/or 5-ASA, irrespective of the activity of CD; in one case TD developed during infliximab treatment (58). Unfortunately, there are no data on intestinal histology in TD patients and it is not clear if TD could be considered an EIM of CD; interestingly, cross-reacting antibodies against gut mucosa and aortic tissue were found in some patients (42).…”

Section: Vasculitismentioning

confidence: 95%

Rheumatologic and extraintestinal manifestations of inflammatory bowel diseases

2016

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Inflammatory bowel diseases (IBDs) often present as a complex inflammatory process wherein colon lesions (ulcerative colitis, UC) or widespread ulceration and fissure (Crohn's disease, CD) might be accompanied by ancillary extraintestinal manifestations (EIMs) that could involve almost every organ system, but also by autoimmune disorders ranging from psoriasis and rheumatoid arthritis to connective tissue diseases. Certain EIMs are more common related to the activity of the IBD (joint, skin, ocular and oral manifestations), other EIMs typically run a course independent of the IBD activity (hepatobiliary disorders) and some are non-specific disorders (osteoporosis and amyloidosis). This paper reviews the most common extraintestinal and rheumatologic manifestations of UC and CD. They may produce greater morbidity than the underlying intestinal disease and may even be the initial presenting symptoms of the IBD. Thus, early recognition of these manifestations should help guide therapy that will reduce overall morbidity in affected patients. Key Message A complete review on the most common extraintestinal and rheumatologic manifestations of ulcerative colitis and Crohn's disease.

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Takayasu's Arteritis in a Patient with Crohn's Disease: An Unexpected Association during Infliximab Therapy

Abstract: We report a 20-year-old

Cited by 21 publications

References 26 publications

Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?

Takayasu's arteritis occurring under TNF-α blockers: a new paradoxical effect?

Effect of infliximab on inflammatory bowel disease with Takayasu arteritis: case series and review of the literature

Rheumatologic and extraintestinal manifestations of inflammatory bowel diseases

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