A case of fistulizing Crohn's disease and erythema nodosum managed with adalimumab.
BACKGROUND
A 20-year-old female presented to her gastroenterologist with fevers and right-labial pain and swelling. Painful erythematous nodules developed in her pretibial region soon after admission to a medical ward. She had a 10-year history of Crohn's colitis, perirectal abscesses and fistulizing disease, and had undergone a diverting ileostomy 16 months earlier; however, she was not on any medication for her Crohn's disease owing to her history of drug intolerance and side effects.


METHODS
Physical examination, laboratory investigations, examination under anesthesia, proctoscopy, MRI, and skin biopsy.


METHODS
Active Crohn's disease with perianal fistula and sigmoid colitis, and erythema nodosum.


RESULTS
Subcutaneous injections of adalimumab: an initial 160 mg dose, followed by 80 mg in week 2 and then 40 mg every other week. Antibiotics were also prescribed.
Quin
Alissa
A
Department of Gastroenterology, Naval Medical Center San Diego, San Diego, CA 92134, USA. alissa.quin@med.navy.mil
Kane
Sunanda
S
Ulitsky
Olga
O
D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy*; D004893:Erythema Nodosum / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068879:Adalimumab