Refractory lymphocytic enterocolitis and tumor necrosis factor antagonist therapy.
OBJECTIVE
Lymphocytic enterocolitis is a malabsorptive syndrome characterized by severe small-bowel villous abnormality and crypt hyperplasia and dense infiltrate of lymphocytes throughout the gastrointestinal tract.


METHODS
We present 2 patients with lymphocytic enterocolitis refractory to usual medical therapy who were treated with tumor necrosis factor antagonists.


RESULTS
Both patients had clinical improvement in diarrheal symptoms and intestinal histologic abnormalities.


CONCLUSIONS
Tumor necrosis factor-alpha antagonists such as infliximab or adalimumab may be a new treatment option for patients with severe refractory lymphocytic enterocolitis not responding to corticosteroids.
Aram
Ghazaleh
G
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Bayless
Theodore M
TM
Chen
Zong-Ming
ZM
Montgomery
Elizabeth A
EA
Donowitz
Mark
M
Giardiello
Francis M
FM
D000068879:Adalimumab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D046730:Colitis, Lymphocytic / Q000628:therapy*; D003106:Colon / Q000473:pathology; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D007155:Immunologic Factors / Q000627:therapeutic use*; D000069285:Infliximab; D007421:Intestine, Small / Q000473:pathology; D008853:Microscopy; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007155:Immunologic Factors; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab