A very rare but severe adverse effect of infliximab medication: Colon cancer in an ankylosing spondylitis patient
Öz
Anti-tumor necrosis factor therapies are still suspected of contributing to malignancy development, though it remains unproven. A 53-year-old female patient was admitted to our clinic with the complaints of fatigue, weight loss and rectal bleeding. She suffered from ankylosing spondylitis and had been treated with infliximab. Colonoscopic examination showed bleeding and ulcerated polypoid tumor in the cecum. Pathological examination of the material revealed adenocarcinoma. We discuss the high probability of a serious adverse effect of infliximab as an anti-tumor necrosis factor agent.
Anahtar Kelimeler
Ankylosing spondylitis anti-tumor necrosis factor infliximab malignancy adenocarcinoma
Kaynakça
- Criscione LG, St Clair EW. Tumor necrosis factor-alpha antagonists for the treatment of rheumatic diseases. Curr Opin Rheumatol 2002; 14: 204–11.
- Knight D, Trinh M, Le J, et al. Construction and initial characterization of a mouse–human chimeric anti-TNF antibody. Mol Immunol 1993; 30: 1443–53.
- Braun J, Baraliakos X, Golder W, et al. Magnetic resonance imaging exa- minations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: evaluation of a new scoring system. Arthritis Rheum 2003; 48: 1126–36.
- Carswell EA, Old LJ, Kassel RL, et al. An endotoxin-induced serum factor that causes necrosis of tumours. Proc Natl Acad Sci USA 1975; 72: 3666–70.
- Feltelius N, Ekbom A, Blomqvist P. Cancer incidence among patients with ankylosing spondylitis in Sweden 1965-95: a population based co- hort study. Ann Rheum Dis 2003; 62: 1185-8.
- Thomas E, Brewster DH, Black RJ, Macfarlane GJ. Risk of malignancy among patients with rheumatic conditions. Int J Cancer 2000; 88: 497-502.
- Bongartz T, Sutton AJ, Sweeting MJ, et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomi- zed controlled trials. JAMA 2006; 295: 2275-85.
- Nestorov I. Clinical pharmacokinetics of TNF antagonists: how do they differ? Semin Arthritis Rheum 2005; 34: 12-8.
- St Clair EW, van der Heijde DM, Smolen JS, et al.; Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset Study Group. Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, con- trolled trial. Arthritis Rheum 2004; 50: 3432-43.
- Lipsky PE, van der Heijde DM, St Clair EW, et al.; Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. Infliximab and methotrexate in the treatment of rheumatoid art- hritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000; 343: 1594-602.
İnfliximab ile tedavi edilen ankilozan spondilitli bir hastada kolon kanseri: Anti-TNF tedavinin olası bir ciddi yan etkisi
Öz
Henüz kanıtlanmamış olmasına rağmen anti-tümör nekrozis faktör tedaviye bağlı kanser gelişimi halen tartışmalıdır. Elli üç yaşında bir kadın hasta halsizlik, kilo kaybı ve rektal kanama şikayeti ile kliniğimize başvurdu. Ankilozan spondilit tanısı alan hasta infliksimab ile tedavi edildi. Kolonoskopik incelemede çekumda ülsere ve kanayan polipoid görünümlü bir lezyon izlendi. Biyopsi materyalinin patolojik incelemesi adenokarsinom ile uyumlu idi. Biz bu vakada infliksimab gibi anti-tümör nekrozis faktör olan bir ilacın ciddi bir yan etkisi olasılığını tartıştık.
Anahtar Kelimeler
Ankilozan spondilit anti-TNF infliksimab malignansi adenokarsinom
Kaynakça
- Criscione LG, St Clair EW. Tumor necrosis factor-alpha antagonists for the treatment of rheumatic diseases. Curr Opin Rheumatol 2002; 14: 204–11.
- Knight D, Trinh M, Le J, et al. Construction and initial characterization of a mouse–human chimeric anti-TNF antibody. Mol Immunol 1993; 30: 1443–53.
- Braun J, Baraliakos X, Golder W, et al. Magnetic resonance imaging exa- minations of the spine in patients with ankylosing spondylitis, before and after successful therapy with infliximab: evaluation of a new scoring system. Arthritis Rheum 2003; 48: 1126–36.
- Carswell EA, Old LJ, Kassel RL, et al. An endotoxin-induced serum factor that causes necrosis of tumours. Proc Natl Acad Sci USA 1975; 72: 3666–70.
- Feltelius N, Ekbom A, Blomqvist P. Cancer incidence among patients with ankylosing spondylitis in Sweden 1965-95: a population based co- hort study. Ann Rheum Dis 2003; 62: 1185-8.
- Thomas E, Brewster DH, Black RJ, Macfarlane GJ. Risk of malignancy among patients with rheumatic conditions. Int J Cancer 2000; 88: 497-502.
- Bongartz T, Sutton AJ, Sweeting MJ, et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomi- zed controlled trials. JAMA 2006; 295: 2275-85.
- Nestorov I. Clinical pharmacokinetics of TNF antagonists: how do they differ? Semin Arthritis Rheum 2005; 34: 12-8.
- St Clair EW, van der Heijde DM, Smolen JS, et al.; Active-Controlled Study of Patients Receiving Infliximab for the Treatment of Rheumatoid Arthritis of Early Onset Study Group. Combination of infliximab and methotrexate therapy for early rheumatoid arthritis: a randomized, con- trolled trial. Arthritis Rheum 2004; 50: 3432-43.
- Lipsky PE, van der Heijde DM, St Clair EW, et al.; Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. Infliximab and methotrexate in the treatment of rheumatoid art- hritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med 2000; 343: 1594-602.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2011 |
| Yayımlandığı Sayı | Yıl 2011 Cilt: 19 Sayı: 3 |