Cytomegalovirus colitis in a patient with Behcet's disease receiving tumor necrosis factor alpha inhibitory treatment.
Anti-tumor necrosis factor alpha (TNF-alpha) inhibitors are effective in the treatment of various inflammatory rheumatic conditions. Increased risks of serious infections are the major issues concerning the long-term safety of these agents. We present a case of a young male Behcet's patient whose disease was complicated by cytomegalovirus (CMV) colitis. Colitis started 10 d after the third Infliximab dose and responded to the cessation of TNF blocking treatment and administration of ganciclovir. Tumor necrosis factor alpha and interferon gamma act at several levels in combating viral infections. CMV infections should be kept in mind and included in the differential diagnosis of severe gastrointestinal symptoms in patients receiving anti-TNF agents.
Sari
Ismail
I
Dokuz Eylul Universitesi Tip Fakultesi Ic hastaliklari ABD Immunoloji-Romatoloji BD 35340 Inciralti, Izmir 35340, Turkey.
Birlik
Merih
M
Gonen
Can
C
Akar
Servet
S
Gurel
Duygu
D
Onen
Fatos
F
Akkoc
Nurullah
N
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001528:Behcet Syndrome / Q000188:drug therapy*; D003092:Colitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000998:Antiviral Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D015774:Ganciclovir