title: Immunoadsorption with tryptophan columns: a therapeutic option for the treatment of rheumatoid arthritis with septic complications.
abstract: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease affecting multiple organs and tissues. Although there is a wide range of therapeutic applications, the coexistence of severe side effects and contraindications outlines the necessity of new therapeutic options in the treatment of severe RA. We report on the case of a 71-year-old patient with successful treatment of a complicated RA with tryptophan immunoadsorption combined with low-dose steroids. Bacterial spondylitis developed in this patient during long-term treatment with infliximab and methotrexate. Weekly immunoadsorption sessions with tryptophan columns resulted in continuous suppression of RA activity over a period of more than 5 months, as indicated by laboratory findings, the disease activity score, and the visual analog scale. This is the first report of successful treatment of a refractory and complicated RA using tryptophan immunoadsorption columns. In conclusion, immunoadsorption is a safe and effective therapeutic alternative, which should be considered to bridge infectious complications in patients with severe RA.
authors.affiliation: Sana Rheumatology Centre Bad Kreuznach, Bad Kreuznach, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thomaidis
authors.forename: Corinna
authors.initials: C
authors.lastname: Schorn
authors.forename: Wolfram
authors.initials: W
authors.lastname: Flaig
authors.forename: Gerwinn
authors.initials: G
authors.lastname: Lingg
authors.forename: Elke
authors.initials: E
authors.lastname: Schönhals
authors.forename: Reinhard
authors.initials: R
authors.lastname: Klingel
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Andreas
authors.initials: A
authors.lastname: Schwarting
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000382:microbiology / Q000628:therapy*; D001424:Bacterial Infections; D006801:Humans; D007163:Immunosorbent Techniques; D018805:Sepsis / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D013166:Spondylitis / Q000382:microbiology; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome; D014364:Tryptophan / Q000627:therapeutic use*
chemical_list: D013256:Steroids; D014364:Tryptophan