Antitumor necrosis factor-alpha therapy for early postoperative recurrence of gastrointestinal Behçet's disease: report of a case.
Behçet's disease is a chronic, relapsing, systemic inflammatory disease characterized by recurrent oral and genital ulcers, skin lesions, and ocular lesions. Gastrointestinal tract is occasionally involved in Behçet's disease, and the typical gastrointestinal lesions are punched-out, discrete mucosal ulcerations. Corticosteroids, 5-aminosalicylic acid derivatives, thalidomide, and immunomodulators have been used to treat Behçet's disease. Some patients with gastrointestinal Behçet's disease undergo surgical management because of the refractoriness to these medical measures or complications, such as perforation and bleeding. Even after successful surgery, postoperative complications, such as poor healing of the anastomosis site and postoperative ulcer recurrence, are so common that repeated operations are frequently required. However, there have been few reports addressing the most effective way to reduce and treat postoperative complications and recurrences. We describe a patient with Behçet's disease involving the distal ileum, who was treated with infliximab as rescue therapy of an unhealed anastomosis site and early recurrent ulcers after a distal ileocecectomy because of persistent bleeding. Abdominal pain from recurrent ulcers improved by the fifth day after the infliximab infusion and almost disappeared by the second week. An ileocolonoscopy performed 15 days after the infliximab infusion showed near complete healing of the recurrent ulcers. This report suggests that infliximab may be an effective novel therapy for the management of early postoperative complications and recurrences in gastrointestinal Behçet's disease.
Byeon
Jeong-Sik
JS
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Choi
Eun Kwang
EK
Heo
Nae Yun
NY
Hong
Seok Chan
SC
Myung
Seung-Jae
SJ
Yang
Suk-Kyun
SK
Kim
Jin-Ho
JH
Song
Jae-Kwan
JK
Yoo
Bin
B
Yu
Chang Sik
CS
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D001528:Behcet Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D003113:Colonoscopy; D003131:Combined Modality Therapy; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012008:Recurrence
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab