HLA-B27 associated spondyloarthropathy, vasculitis, and amyloid enteropathy: response to infliximab.
In 2000 we described a patient with HLA-B27 associated spondyloarthropathy (SpA) and severe ascending aortitis requiring surgical intervention. Despite continued immunosuppressive therapy she developed narrowing of the distal part of the right subclavian artery and proximal axillary artery secondary to active vasculitis. In addition, biopsy-proven amyloid gastroenteropathy developed causing persistent diarrhea and iron deficiency anemia. Treatment with infliximab resulted in resolution of joint symptoms and rapid improvement in laboratory markers of inflammation. Diarrhea settled more gradually, such that her bowel habit had normalized 16 months after therapy commenced.
Stamp
Lisa K
LK
Department of Medicine and Health Sciences, Christchurch School of Medicine, Otago University, Christchurch, New Zealand. lisa.stamp@cdhb.govt.nz
O'Donnell
John L
JL
D000328:Adult; D000686:Amyloidosis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001025:Aortitis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D000069285:Infliximab; D008727:Methotrexate / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D025242:Spondylarthropathies / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D015796:HLA-B27 Antigen; D000069285:Infliximab; D011241:Prednisone; D008727:Methotrexate