The development of Crohn's disease, a paradoxical side effect in a patient who used adalimumab for the treatment of ankylosing spondylitis

Öz

Anti-tumor necrosis factor agents are highly effective drugs for inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease. Paradoxical side effects related with these agents have been reported in recent years, primarily as case reports. Ankylosing spondylitis is one of the rheumatoid diseases treated with adalimumab, a tumor necrosis factor inhibiting anti-inflammatory drug. In this report we describe the case of a patient with ankylosing spondylitis who developed Crohn's disease, a paradoxical side effect in the use of adalimumab.

Anahtar Kelimeler

• Paradoxical Crohn's disease

Ankilozan spondilit nedeniyle adalimumab kullanan bir hastada paradoksal olarak gelişen Crohn hastalığı

Öz

Anti-tümör nekrozis faktör ajanlar, romatizmal hastalıklar ve inflamatuvar barsak hastalığı gibi farklı inflamatuvar durumlarda yüksek oranda etkili ilaçlardır. Bu ajanlara bağlı olarak gelişen paradoksal yan etkilerle ilgili son yıllarda, çoğu vaka bildirimi şeklinde olan yayınlar mevcuttur. Anti-tümör nekrozis faktör ajanların en sık kullanıldığı romatizmal hastalıklardan birisi de ankilozan spondilittir. Biz bu yazıda adalimumab kullanan ankilozan spondilitli bir hastada paradoksal olarak gelişen Crohn hastalığını sunmayı amaçladık

Anahtar Kelimeler

• Paradoksal Crohn hastalığı

Kaynakça

1. Braun J, Baraliakos X, Listing J, et al. Differences in the incidence of flares or new onset of inflammatory bowel diseases in patients with ankylosing spondylitis exposed to therapy with anti-tumor necrosis factor alpha agents. Arthritis Rheum 2007;57:639-47.
2. Braun J, Sieper J. Biological therapies in the spondyloarthritides-the current state. Rheumatology 2004;43:1072-84.
3. Fouache D, Goeb V, Massy-Guillemant N, et al. Paradoxical ad- verse events of anti-tumour necrosis factor therapy for spondy- loarthropathies: a retrospective study. Rheumatology (Oxford) 2009;48:761-4.
4. Sandborn WJ, Hanauer SB, Katz S, et al. Etanercept for active Cro- hn’s disease: a randomized, double-blind, placebo-controlled trial. Gastroenterology 2001;121:1088-94.
5. Toussirot E, Houvenagel E, Goeb V, et al. Development of inf- lammatory bowel disease during anti-TNF-a therapy for inflam- matory rheumatic disease: a nationwide series. Joint Bone Spine 2012;79:457-63.