TAILIEUCHUNG - Báo cáo y học: "Anorectal stenosis after treatment with tumor necrosis factor a antibodies: a case series."

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Anorectal stenosis after treatment with tumor necrosis factor a antibodies: a case series. | Slattery et al. Journal of Medical Case Reports 2010 4 226 http content 4 1 226 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Anorectal stenosis after treatment with tumor necrosis factor a antibodies a case series Eoin Slattery Denise Keegan Diarmuid O Donoghue Abstract Introduction We identified three patients who developed anorectal stenosis after successful treatment with antitumor necrosis factor a anti-TNF-a agents. Case presentation Two patients a 24-year-old Irish Caucasian man and a 64-year-old Irish Caucasian woman developed symptoms attributable to anorectal stenosis four to six weeks after treatment. A further patient a 25-year-old Irish Caucasian male presented three years after treatment with anorectal stenosis having been asymptomatic with his stenosis for the preceding three years. No patients had evidence of active inflammation at time of representation or had previous anal canal surgery. Conclusion Anorectal stenosis in these patients appears to be independent of active inflammation. No other cause of new stenosis could be identified. We postulate that rapid clinical response to anti-TNF-a agents led to aberrant mucosal healing. This in turn led to anorectal stenosis. This is the first report of this complication in association with the use of biologic agents. Introduction Tumor necrosis factor a antibodies anti-TNF-a have become widely used in the treatment of chronic inflammatory bowel disease IBD . TNF-a is a proinflamma-tory cytokine that plays a central role in the pathogenesis of IBD. Currently infliximab is licensed for use in moderate to severe Crohn s disease CD and ulcerative colitis UC 1 2 . Newer anti-TNF-a agents including adalimumab and more recently certolizumab pegol have been licensed for use in patients with CD. Efficacy rates in excess of 40 to 60 have been reported for infliximab 3-6 . These potent drugs are tolerated well but are associated with potentially significant adverse .

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