Short-Term Response to Infliximab in Rheumatoid Pattern Polyarthropathy Complicating Ulcerative Colitis
Abstract
Ulcerative colitis (UC) is a progressive inflammatory disease (IBD) of the bowel which can be accompanied by extraintestinal findings such as peripheral and axial arthropathies. Patients with UC sometimes display rheumatoid pattern polyarthropathy which is challenging to differ from rheumatoid arthritis. We describe a case with rheumatoid pattern polyarthropathy complicating UC and her favourable response to infliximab therapy. A 25-year-old female with a diagnosis of UC was admitted due to swelling and pain in multiple joints. Laboratory tests revealed elevated acute phase reactants. Since the patient was refractory to the combination therapy comprising methotrexate, sulphasalazine and steroid, she was started on an infliximab regimen. She experienced an improvement both in terms of pain scores and biochemical findings. The patient was asymptomatic with reduced acute phase reactants following a 6-monthcourse of anti-tumor necrosis factor (anti-TNF) therapy. Infliximab serves as an effective treatment option for the management of rheumatoid pattern peripheral polyarthritis associated with UC.
Keywords
anti-TNF, arthritis, infliximab, polyarthropathy, ulcerative colitis
Kaynakça
- Andrisani G, Guidi L, Papa A, Armuzzi A. Anti-TNF alpha therapy in the management of extraintestinal manifestation of inflammatory bowel disease. Eur Rev Med Pharmacol Sci. 2012;16:890-901.
- D'Incà R, Podswiadek M, Ferronato A, Punzi L, Salvagnini M, Sturniolo GC. Articular manifestations in inflammatory bowel disease patients: a prospective study. Dig Liver Dis 2009;41:11565-9.
- Orchard TR, Orchard TR, Wordsworth BP, Jewell DP. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 1998;42:387-91.
- Dorofeyev AE, Vasilenko IV, Rassokhina OA. Joint extraintestinal manifestations in ulcerative colitis. Dig Dis 2009;27: 502-10.
- Boyer F, Fontanges E, Miossec P. Rheumatoid arthritis associated with ulcerative colitis: a case with severe flare of both diseases after delivery. Ann Rheum Dis. 2001;60:901. Ulker A, et al. Peripheral arthritis in the course of inflammatory bowel diseases. Dig Dis Sci. 2011;56:183-7.
- Orchard TR, Thiyagaraja S, Welsh KI, Wordsworth BP, Hill Gaston JS, Jewell DP. Clinical phenotype is related to HLA genotype in the peripheral arthropathies of inflammatory bowel disease. Gastroenterology. 2000;118:274-8.
- Cruz VA, Yamaguchi L, Ribeiro CN, Magalhães Vde O, Rego J, Silva NA. Ulcerative colitis and rheumatoid arthritis: a rare association--case report. Rev Bras Reumatol. 2012;52:648-50.
- Lesuis N, Befrits R, Nyberg F, van Vollenhoven RF. Gender and the treatment of immune-mediated chronic inflammatory diseases: rheumatoid arthritis, inflammatory bowel disease and psoriasis: an observational study. BMC Med. 2012;10:82.
- Kollias G, Douni E, Kassiotis G, Kontoyiannis D. On the role of tumor necrosis factor and receptors in models of multiorgan failure, rheumatoid arthritis, multiple sclerosis and inflammatory bowel disease. Immunol Rev. 1999;169:175-94.
