Development of Crohn's disease in a patient with multiple sclerosis treated with copaxone.
BACKGROUND
Copaxone (glatiramer acetate) is a synthetic copolymer mimicking a portion of myelin basic protein, one of several putative autoantigens in multiple sclerosis (MS). Copaxone suppresses the production of tumor necrosis factor (TNF)-alpha, a key mediator of inflammation in MS as well as in other pathologies, such as colitis of interstitial bowel disease (IBD). Copaxone is a drug approved for the treatment of MS, and one that is very well tolerated with a high safety profile and relatively few side effects. Crohn's disease has not been associated with its administration.


METHODS
We describe a patient with MS in remission who had not exhibited any signs of IBD in the past. She had been on Copaxone 20 mg/day treatment for 2 years when she first exhibited gastrointestinal symptoms.


RESULTS
Our patient developed Crohn's disease while on Copaxone treatment as a consequence of long-term immunosuppression.


CONCLUSIONS
Clinicians should be aware that Crohn's disease is a potential novel adverse drug effect of Copaxone.
Charach
Gideon
G
Department of Internal Medicine C, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. drcharach@012.net.il
Grosskopf
Itamar
I
Weintraub
Moshe
M
D000328:Adult; D015897:Comorbidity; D003424:Crohn Disease / Q000139:chemically induced* / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D007082:Ileum / Q000473:pathology; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology; D010455:Peptides / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D010455:Peptides; D000068717:Glatiramer Acetate