Treatment of therapy-resistant perineal metastatic Crohn's disease after proctectomy using anti-tumor necrosis factor chimeric monoclonal antibody, cA2: report of two cases.
OBJECTIVE
Two young females with well-documented Crohn's disease and nonhealing perineal wounds following proctectomy compatible with "metastatic Crohn's disease" are described. We hypothesized that metastatic Crohn's disease would be a tumor necrosis factor-dependent inflammatory reaction and have treated these two patients with the anti-tumor necrosis factor chimeric monoclonal antibody, cA2.


RESULTS
Administration of cA2 was followed by a rapid reduction of subjective and objective parameters of inflammation and caused a substantial reduction of the wound size.


CONCLUSIONS
These preliminary data are consistent with a tumor necrosis factor-dependent inflammatory cause of Crohn's disease and its extraintestinal manifestations and provide support for targeting tumor necrosis factor in this condition.
van Dullemen
H M
HM
Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
de Jong
E
E
Slors
F
F
Tytgat
G N
GN
van Deventer
S J
SJ
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001706:Biopsy; D002097:C-Reactive Protein / Q000032:analysis; D003424:Crohn Disease / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010502:Perineum / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein