Treatment of severe esophageal Crohn's disease with infliximab.
Esophageal ulceration with fistula is an uncommon manifestation of Crohn's disease. Typical presentation of symptomatic esophageal Crohn's disease may include dysphagia, odynophagia, weight loss, and chest discomfort. We present a patient with severe esophageal and skin involvement of Crohn's disease that was progressive despite conventional therapy including prednisone and 6-mercaptopurine. The diagnosis of Crohn's was based on the presence of typical clinical, endoscopic, and pathologic findings, including granulomas in the skin ulcer and the absence of infectious etiologies. The patient had a nearly complete resolution of her esophageal disease with a single infusion of infliximab.
Heller
T
T
Department of Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
James
S P
SP
Drachenberg
C
C
Hernandez
C
C
Darwin
P E
PE
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004935:Esophageal Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D004937:Esophageal Fistula / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000069285:Infliximab