Oral ulcerations are associated with the loss of response to infliximab in Crohn's disease.

Abstract

We describe a 25-year-old Caucasian man with a 13-year history of inflammatory Crohn's disease (CD) who was suffering recurrent severe oral and esophageal ulcerations for the past 3 years. His CD had been treated with infliximab infusions among other medications. The loss of efficacy was confirmed by antibodies to infliximab (ATI) and serum infliximab tests that showed high levels of ATIs and undetectable levels of infliximab respectively. These findings were consistent with significant immunogenic response to infliximab leading to loss of effect. Infliximab infusions and prednisone were discontinued and treatment of the CD was instituted with adalimumab, a human anti-tumor necrosis factor (TNF)-alpha biologic agent, to control the inflammatory small intestinal disease and dapsone for the oral and esophageal CD ulcerations. The patient's oral and esophageal lesions as well as the enteric CD are under control after 5 months of therapy.

• Authors: A R Sánchez, R S Rogers 3rd, P J Sheridan
• Journal: Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology (J Oral Pathol Med) Vol. 34 Issue 1 Pg. 53-5 (Jan 2005) ISSN: 0904-2512 [Print] Denmark
• PMID: 15610407 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Dermatologic Agents
• Infliximab
• Adalimumab

Topics

• Adalimumab
• Adult
• Antibodies, Monoclonal (immunology, therapeutic use)
• Antibodies, Monoclonal, Humanized
• Crohn Disease (complications, drug therapy)
• Dermatologic Agents (immunology, therapeutic use)
• Drug Tolerance
• Esophageal Diseases (drug therapy, etiology)
• Humans
• Infliximab
• Male
• Oral Ulcer (drug therapy, etiology)
• Ulcer (drug therapy, etiology)